Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2024-04-10-106

Project Information

Project IdentifiersProject ID: 209698
DEA: 072332E4
EFIS: 0700000391
COOP: 0705187
DIST-CO-RTE-PM07-LA-I-5-45.4/54
Award Date07/01/2021
Closeout DateNot set
Work DescriptionAddition of 14 miles of HOV lanes in both directions would extend existing carpool lanes on the I- 5 in San Fernando Valley to Santa Clarita Valley
Location DescriptionThe I-5 North Capacity Enhancements Project focuses on improvements to the I-5 freeway from cities of Santa Clarita and Castaic, beginning at the SR-14 interchange to Parker Rd.
QA Service Level2 (Verified on 02/03/2021)

Sample Information

Sample Taken Date04/10/2024 Sample Unique Key106
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 testing04/11/2024
Sample typeQuality Control A brief description of the samplestructural concrete
The quantity of what the sample constitutes2 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byDerek Last name of sampler or witnessed byBezotte
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNational Ready Mix Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberS63C451T1
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected291604
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collected-5 SB RW 2535 Stem Sta. 21+25 Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments