Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-05-11-77

Project Information

Project IdentifiersProject ID: 993807
DEA: 07353304
EFIS: 0718000272
DIST-CO-RTE-PM07-LA-110-23.1
Award Date11/03/2022
Closeout DateNot set
Work DescriptionREPLACE BRIDGE RAILING WITH CONCRETE BARRIER. AND UPGRADE LIGHTING.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES AT THIRD STREET OVERCROSSING
QA Service Level1 (Verified on 05/11/2022)

Sample Information

Sample Taken Date05/11/2023 Sample Unique Key77
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes10 Cy From where was the sample collectedJob Site
First name of sampler or witnessed byAziz Last name of sampler or witnessed byJavahery
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNATIONAL READY MIXED CONCRETE Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberS72500
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected658038
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

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Test File Attachments