DIME - Sample Record for DIME Sample ID 2023-08-01-20

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Sample Record

DIME Sample ID 2023-08-01-20

Project Information

Project Identifiers	Project ID: 213749 DEA: 120C1104 EFIS: 1200000633
DIST-CO-RTE-PM	12-ORA-57-20.3/21.6
Award Date	04/19/2019
Closeout Date	05/28/2024
Work Description	SR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location Description	ORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level	1 (Verified on 05/31/2019)

Owner Lab

CT HQ - QASI Los Angeles Field Office

Sample Information

Sample Taken Date	08/01/2023	Sample Unique Key	20
Date that the sample was received by the laboratory/organization performing the testing	08/08/2023	Sample type	Per Request
A brief description of the sample	Repair material for CIP	The quantity of what the sample constitutes	1 bag of part A 1 container of part B and 1 bag of Agg
From where was the sample collected	Job Site	First name of sampler or witnessed by	Keivan
Last name of sampler or witnessed by	Hassan	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Sika Corporation
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Information

Material Type	Cementitious	Brand	Sikatop 122 plus
Mill	NA	Type of Cementitious Material	Blended Cement

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Date Added	Verified?	Release Date	Test Comments	Privacy Level	Actions
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