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Sample Record for 2020-12-01-10

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

Project Information

Project ID: 213970 DEA: 080K1214 EFIS: 0815000245 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-12.5/14.8
Work Description: REPLACE PCC PAVEMENT WITH JPCP AND PRECAST JOINTED CONCRETE PAVEMENT.
Location Description: SAN BERNARDINO COUNTY IN FONTANA AND NEAR DEVORE FROM 0.3 MILE SOUTH OF SIERRA AVENUE UNDERCROSSING TO GLEN HELEN PARKWAY UNDERCROSSING
Contractor Name: OHL USA, INC
Contractor Address: 1920 MAIN STREET STE 310, Irvine, CA 92614
Resident Engineer: Vu Thanh Nguyen Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-12-01-10
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Hesperia Field Testing Laboratory
Sample Organization Contact: (951) 840-8242
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 12/01/2020
Date that the sample was received by the laboratory/organization performing the testing: 12/01/2020
The quantity of what the sample constitutes: 2
A brief description of the sample: Type II
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Robertsons Rialto

Material Information

The concrete mix design number: LB0600AB
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 5869036
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Back of Truck
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

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.