Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-12-08-15
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214670 DEA: 07331004 EFIS: 0716000220 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-101-9.0/9.2 |
| Award Date | 04/13/2022 |
| Closeout Date | 11/06/2024 |
| Work Description | CONCRETE SLAB REPLACEMENT & GRIND, PAVEMENT & RESURFACE ACE |
| Location Description | VENTURA COUNTY IN THOUSAND OAKS FROM NORTHBOUND OFF-RAMP TO SOUTHBOUND OFF-RAMP AT CONEJO COMMERCIAL VEHICLE ENFORCEMENT FACILITIES |
| QA Service Level | 1 (Verified on 07/12/2021) |
Sample Information
| Sample Taken Date | 12/08/2022 | Sample Unique Key | 15 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 12/08/2022 |
| Sample type | Department Acceptance | A brief description of the sample | ISR-RSC |
| The quantity of what the sample constitutes | 200 CY plus | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | PHILIP | Last name of sampler or witnessed by | MAQUIRAN |
| Title of sampler | MREA | Telephone number of sampler | 12133581518 |
| Laboratory sample identification | 22-3165 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Powell Construction | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | CTS-65-EHI |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 1 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Wheelbarrow from Chute volumetric truck | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-12-08-15-1 CTM 524-March 2013 (Verified)