Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2023-09-25-69
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994351 DEA: 07322004 EFIS: 0716000053 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-118-R11.0/R14.0 |
| Award Date | 01/11/2023 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT STORMWATER TREATMENT DEVICES. |
| Location Description | THE CITY AND COUNTY OF LOS ANGELES FROM 0.1 MILE WEST OF ARLETA AVENUE UNDERCROSSING TO 0.1 MILE WEST OF ROUTE 118/210 SEPARATION |
| QA Service Level | 1 (Verified on 06/08/2023) |
Sample Information
| Sample Taken Date | 09/25/2023 | Sample Unique Key | 69 |
|---|---|---|---|
| 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 | 09/27/2023 |
| Sample type | Department Acceptance | A brief description of the sample | 6X12 PCC cylinder |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Arian | Last name of sampler or witnessed by | Angha |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 23-481 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | National Ready Mix Concrete Company | Transportation Laboratory (TL) Number | 002 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | S63C451T1 |
|---|---|---|---|
| The truck number from where the sample was collected | 1 | The batch plant ticket number from where the sample was collected | 693119 |
| Concrete batch plant | National Ready Mix | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | truck chute | 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: 2023-09-25-69-1 CTM 521-June 2020 (Verified)