Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-05-12-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-710-6.0-9.4 |
| Award Date | 09/02/2011 |
| Closeout Date | Not set |
| Work Description | Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing. |
| Location Description | Port of Long Beach (District 7) |
| QA Service Level | 1 (Verified on 06/03/2013) |
Sample Information
| Sample Taken Date | 05/12/2017 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 testing | 05/17/2017 |
| Sample type | Quality Control | A brief description of the sample | 6X12 |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | HLA | Last name of sampler or witnessed by | KYI |
| Title of sampler | ASSISTANT IQA ENGINEER | Telephone number of sampler | |
| Laboratory sample identification | 833-P3 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | ON SITE | Transportation Laboratory (TL) Number | 051217 RW-P LCC POUR3 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | OCEAN BLVD TO SR 47 IN LB | |
| Structure name | RW P LCC POUR3 CLASS III |
Material Information
| Material Type | Concrete | The concrete mix design number | MIXED ON SITE |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | NA | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | TREMIIE PIPE | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||