Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2024-04-11-74
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 995498 DEA: 072XL104 EFIS: 0724000158 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-14.23 |
| Award Date | 11/11/2023 |
| Closeout Date | 11/04/2025 |
| Work Description | LA-10, Construct temporary structural shoring - Column Casings Repair Work |
| Location Description | I-10 at Olympic Blvd |
| QA Service Level | 1 (Verified on 11/20/2023) |
Sample Information
| Sample Taken Date | 04/11/2024 | Sample Unique Key | 74 |
|---|---|---|---|
| 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 | 04/30/2024 |
| Sample type | Department Acceptance | A brief description of the sample | 4X8 PCC cylinders |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Aziz | Last name of sampler or witnessed by | Javahery |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 24-066 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Security Paving company | Transportation Laboratory (TL) Number | 04-11-66 |
| 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 | 45ESCC |
|---|---|---|---|
| The truck number from where the sample was collected | 3823 | The batch plant ticket number from where the sample was collected | 1922219 |
| Concrete batch plant | Security Paving Company | 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: 2024-04-11-74-1 CTM 521-June 2020 (Verified)