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Sample Record for 2020-10-18-6

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213746 DEA: 080Q75U4 EFIS: 0817000114 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Work Description: REPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location Description:
Contractor Name: J McLoughlin Engineering
Contractor Address: 10641 Fulton Court, Rancho Cucamonga, CA 91730
Resident Engineer: Ashraf Mohamed Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2020-10-18-6
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Field Testing Laboratory
Sample Organization Contact: (951) 840-8328
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 10/18/2020
Date that the sample was received by the laboratory/organization performing the testing: 10/19/2020
The quantity of what the sample constitutes: 3 beams
A brief description of the sample: Concrete beams
From where was the sample collected: Job Site
Laboratory sample identification: 60J-6A, 60J-6B, 60J-6C
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: RV Concrete Inc

Material Information

The concrete mix design number: RVC-60-1
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: TT1
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: On Job Site at Concrete Truck
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.