Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2023-04-15-10
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993844 DEA: 070W1004 EFIS: 0721000043 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-31.8/42.6 |
| Award Date | 06/28/2022 |
| Closeout Date | Not set |
| Work Description | PLACE RUBBERIZED HMA (GAP GRADED) |
| Location Description | LOS ANGELES COUNTY IN BURBANK AND LOS ANGELES FROM COHASSET STREET UNDERCROSSING TO ROXFORD STREET UNDERCROSSING |
| QA Service Level | 1 (Verified on 09/20/2022) |
Sample Information
| Sample Taken Date | 04/15/2023 | Sample Unique Key | 10 |
|---|---|---|---|
| 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 | 04/15/2023 |
| Sample type | Department Acceptance | A brief description of the sample | 6x6x21 beams |
| The quantity of what the sample constitutes | 200 yd3 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Rosauro | Last name of sampler or witnessed by | Nogoy |
| Title of sampler | TEC | Telephone number of sampler | 2137939321 |
| Laboratory sample identification | 23-0448 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | George Throop | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 2010-007 |
|---|---|---|---|
| The truck number from where the sample was collected | 0 | 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 | Discharge from concrete truck into wheelbarrow. | 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: 2023-04-15-10-1 CTM 524-March 2013 (Verified)