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Sample Record for 2015-02-26-6

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

Project Information

Project ID: 3959 DEA: 072159C4 EFIS: 0700000339 QA Service Level: 1
DIST-CO-RTE-PM: 07-LA-5-001.8/003.0
Work Description: CARMENITA INTERCHANGE IMPROVEMENT
Location Description: LOS ANGELES COUNTY IN SANTA FE SPRINGS AND NORWALK FROM ALONDRA BOULEVARD OVERCROSSING TO SHOEMAKER AVENUE OVERCROSSING
Contractor Name: FLATIRON WEST INC
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MAROCS, CA 90278
Resident Engineer: Peter M. Lee Structure Rep.: Bassem Kabbara

Sample Information

DIME Sample ID: 2015-02-26-6
TL Number from the TL Form: 199540
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 02/26/2015
Date that the sample was received by the laboratory/organization performing the testing: 03/11/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification: 856-40
Structure unique identifier: SW205
Structure name: GRADE BEAMS
The fabricator/manufacturer/facility name: FIELD

Material Information

The concrete mix design number: S62578
The truck number from where the sample was collected: NOT PROVIDED
The batch plant ticket number from where the sample was collected: 158897
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: NATIONAL READY MIX
A detailed description of where the material sample was collected: TRUK
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.