Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2023-08-15-47
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Project Information
| Project Identifiers | Project ID: 214670 DEA: 07331004 EFIS: 0716000220 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-101-9.0/9.2 |
| Award Date | 04/13/2022 |
| Closeout Date | 11/06/2024 |
| Work Description | CONCRETE SLAB REPLACEMENT & GRIND, PAVEMENT & RESURFACE ACE |
| Location Description | VENTURA COUNTY IN THOUSAND OAKS FROM NORTHBOUND OFF-RAMP TO SOUTHBOUND OFF-RAMP AT CONEJO COMMERCIAL VEHICLE ENFORCEMENT FACILITIES |
| QA Service Level | 1 (Verified on 07/12/2021) |
Sample Information
| Sample Taken Date | 08/15/2023 | Sample Unique Key | 47 |
|---|---|---|---|
| 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 | 08/17/2023 |
| Sample type | Department Acceptance | A brief description of the sample | PCC Aggregate |
| The quantity of what the sample constitutes | 3 Bags of PCC Aggregate | From where was the sample collected | Source |
| First name of sampler or witnessed by | Avo | Last name of sampler or witnessed by | Karajian |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | National Ready Mix - Moorpark | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-56-0032 |
|---|---|---|---|
| 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 collected | Conveyor Belt | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-08-15-47-5 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-08-15-47-6 CTM 226-July 2010 (Verified)
DIME Test ID: 2023-08-15-47-7 CTM 217-June 2011 (Verified)