Sample Record
Owner Lab
- Alta Vista Solutions - Whittier
DIME Sample ID 2024-06-04-112
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994582 DEA: 073203U4 EFIS: 0722000071 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-91,605-R16.6/R16.8,R0.0/R10.4 |
| Award Date | 06/20/2023 |
| Closeout Date | Not set |
| Work Description | PLACE CONCRETE PAVEMENT AND HIGH FRICTION SURFACE TREATMENT. |
| Location Description | LOS ANGELES COUNTY ON ROUTE 605 FROM 0.2 MILE NORTH OF KATELLA AVENUE UNDECROSSING TO 0.1 MILE NORTH OF TELEGRAPH ROAD UNDERCROSSING AND ON ROUTE 91 FROM 0.4 MILE WEST OF ROUTE 605 UNDERCROSSING TO 0.2 MILE WEST OF ROUTE 605 UNDERCROSSING |
| QA Service Level | 1 (Verified on 07/12/2023) |
Sample Information
| Sample Taken Date | 06/04/2024 | Sample Unique Key | 112 |
|---|---|---|---|
| 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 | 06/04/2024 |
| Sample type | Quality Assurance | A brief description of the sample | 6 x 12 LCB Cylinders |
| The quantity of what the sample constitutes | 2 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Aleksey | Last name of sampler or witnessed by | Souglobov |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 24-1163 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | N/A | 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 | Concrete | The concrete mix design number | 53203 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 7259185 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete from wheelbarrow | 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: 2024-06-04-112-1 CTM 521-June 2020 (Verified)