Sample Record

Owner Labs

  • CT SC Sub-unit 3671-106
  • CT D07 - Field Laboratory

DIME Sample ID 2017-04-27-1

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout DateNot set
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date04/27/2017 Sample Unique Key1
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the samplePortland Cement Concrete
The quantity of what the sample constitutes250 cy From where was the sample collectedJob Site
First name of sampler or witnessed byBrett Last name of sampler or witnessed bySoldano
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert Materials Vernalis 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 number123456
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected123654789
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2017-04-27-1-2ASTM C231-17a: Standard Test Method for Air Content of Freshly Mixed Concrete by the Pressure Method DANNY LALONDECT SC Sub-unit 3671-10604/27/2017 DANNY LALONDE
Yes
05/04/2017