Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-01-24-12
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994068 DEA: 081C7204 EFIS: 0813000003 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-R96.1/R124.3 |
| Award Date | 08/02/2022 |
| Closeout Date | 02/23/2024 |
| Work Description | IMPORTED BORROW, SHOULDER BACKING, AND STRUCTURAL CONCRETE. |
| Location Description | SAN BERNARDINO ABOUT 22 MILES NORTHEAST OF BARSTOW AT VARIOUS LOCATIONS FROM 0.3 MILE SOUTH OF HARVARD ROAD OVERCROSSING TO 0.1 MILE NORTH OF RASOR ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 09/30/2022) |
Sample Information
| Sample Taken Date | 01/24/2023 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 01/25/2023 |
| Sample type | Quality Assurance | A brief description of the sample | Concrete Cylinders |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Alvin | Last name of sampler or witnessed by | Anggito |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 1047-03 | Linked DIME Sample ID | 2023-01-24-12 |
| The fabricator/manufacturer/facility name | Robertsons | Transportation Laboratory (TL) Number | 081C720420230124 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SC590838 |
|---|---|---|---|
| The truck number from where the sample was collected | 1954 | The batch plant ticket number from where the sample was collected | 7420381 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Drainage System 8 -Box Culvert - Both Sides | 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: 2023-01-24-12-1 ASTM C39-10 (Verified)