*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Sample Record for 2018-11-15-2
Project ID: 209695 DEA: 08347704 EFIS: 0800000616 QA Service Level: 1
Work Description: (Alternative Delivery) The CMGC project will upgrade SR 58 from 2- to 4-lanes in San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Location Description: SR-58 / 395 Kramer Junction project. In San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Contractor Name: KIEWIT INFRASTRUCTURE WEST CO. Contractor Address: 2215 E 1ST STREET
Resident Engineer: Shaine Shahidi Structure Rep.: Abdalla, Osama
DIME Sample ID: 2018-11-15-2
TL Number from the TL Form:
Sample Submitted By Organization: CT QASI - Los Angeles Field Laboratory
Sample Organization Contact: (858) 285-5797
Type of Sample: Quality Assurance
Type of Material: Concrete Core
Sample Taken Date: 11/15/2018
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: Mythacalate concrete repair
A brief description of the sample: Concrete Core
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Detail description: Concrete Core
Structure names: SR 58
Type of material: Concrete and Mythacalate