Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-07-24-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 210569 DEA: 083555V4 EFIS: 0814000086 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-42.5/46.0 |
| Award Date | 11/05/2015 |
| Closeout Date | 01/18/2022 |
| Work Description | WIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR. |
| Location Description | SAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 10/15/2015) |
Sample Information
| Sample Taken Date | 07/24/2017 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 07/31/2017 |
| Sample type | Quality Assurance | A brief description of the sample | 6X12 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Md | Last name of sampler or witnessed by | Rahman |
| Title of sampler | Unknown | Telephone number of sampler | Unknown |
| Laboratory sample identification | 934-724 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | ROBERTSONS | Transportation Laboratory (TL) Number | 20170724 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | VICTORVILLE SEPERATION BRIDGE WIDEN AND NEW |
| Structure name | VICTORVILLE SEPERATION BRIDGE WIDEN AND NEW |
Material Information
| Material Type | Concrete | The concrete mix design number | SC675B38 |
|---|---|---|---|
| The truck number from where the sample was collected | 1193 | The batch plant ticket number from where the sample was collected | 2934062 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | TRUCK DISCHARGE LOAD 6 | Where the material sample would have been placed if not sampled | VICTORVILLE SEPERATION BRIDGE WIDEN AND NEW |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
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. | |||