Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2020-03-11-11
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Project Information
| Project Identifiers | Project ID: 208973 DEA: 120H1004 EFIS: 1200000180 COOP: 120670 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-405,73,405,605-9.3/24.3 |
| Award Date | 11/07/2016 |
| Closeout Date | Not set |
| Work Description | (Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP. |
| Location Description | Orange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2 |
| QA Service Level | 1 (Verified on 09/10/2015) |
Sample Information
| Sample Taken Date | 03/11/2020 | Sample Unique Key | 11 |
|---|---|---|---|
| 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 | 03/03/2020 |
| Sample type | Quality Assurance | A brief description of the sample | Bridge deck and Approach slap |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jose | Last name of sampler or witnessed by | Mendez |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | 1200000180Rte405Magnolia St OC | Linked DIME Sample ID | 2020-03-11-11 |
| The fabricator/manufacturer/facility name | Structures | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 55-1121 | |
| Structure name |
Material Information
| Material Type | Roadway/Bridge Surface | Type of Surface | Grind PCC Deck |
|---|---|---|---|
| Date Surface placed | 02/03/2020 | Bridge Number | 55 1121 |
| Bridge Name | Magnolia St OC | Bridge Length | Unknown |
| Number of Lanes | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-03-11-11-1 CTM 342-August 2012 (Verified)