Sample Record
Owner Lab
- Alta Vista Solutions - Whittier
DIME Sample ID 2023-05-22-58
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Project Information
| Project Identifiers | Project ID: 214451 DEA: 07303704 EFIS: 0714000035 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-101-8.0/27.3 |
| Award Date | 12/19/2019 |
| Closeout Date | 05/07/2024 |
| Work Description | REPLACE CONCRETE BARRIERS. |
| Location Description | THE CITY AND COUNTY OF LOS ANGELES FROM PILGRIMAGE OVERCROSSING TO VALLEY CIRCLE BOULEVARD OVERCROSSING |
| QA Service Level | 1 (Verified on 08/12/2020) |
Sample Information
| Sample Taken Date | 05/22/2023 | Sample Unique Key | 58 |
|---|---|---|---|
| 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 | 05/23/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 2 LCB Cylinders |
| The quantity of what the sample constitutes | 10 Cubic Yards | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Aleksey | Last name of sampler or witnessed by | Souglobov |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 23-0690 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | n/a | 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 | S29000 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 625429 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | 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: 2023-05-22-58-1 CTM 521-June 2020 (Verified)