Sample Record

Owner Lab

  • CT D09 - Bishop Field Laboratory

DIME Sample ID 2023-07-20-12

Project Information

Project IdentifiersProject ID: 214135
DEA: 09213404
EFIS: 0900000030
DIST-CO-RTE-PM09-INY-395-29.9/41.8
Award Date10/22/2021
Closeout DateNot set
Work DescriptionROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location DescriptionINYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE
QA Service Level1 (Verified on 05/03/2019)

Sample Information

Sample Taken Date07/20/2023 Sample Unique Key12
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 testing07/20/2023
Sample typeQuality Assurance A brief description of the sampleDrainage System 1354 SL, Footings.
The quantity of what the sample constitutes50 YDS From where was the sample collectedJob Site
First name of sampler or witnessed byJerid Last name of sampler or witnessed byKupelian
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameFisher Sand and Gravel Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)Fisher Sand and Gravel Olancha
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedOlancha Creek Footings
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments