Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-09-05-5
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Project Information
| Project Identifiers | Project ID: 209139 DEA: 071170U4 EFIS: 0700000085 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-33.2/37.2 |
| Award Date | 02/10/2014 |
| Closeout Date | 03/01/2022 |
| Work Description | CONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS. |
| Location Description | LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE WEST OF PUENTE AVENUE UNDERCROSSING TO 0.2 MILE EAST OF HOLLENBECK STREET UNDERCROSSING |
| QA Service Level | 1 (Verified on 05/06/2014) |
Sample Information
| Sample Taken Date | 09/05/2017 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 09/07/2017 |
| 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 | Nelson | Last name of sampler or witnessed by | Pereira |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 882-974 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Holliday Rock | Transportation Laboratory (TL) Number | 878974 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | 736 SV at Sunset Ave SW1847 between station 1846 32 to 1846 92 Barrier rail |
| Structure name | 736 SV at Sunset Ave SW1847 between station 1846 32 to 1846 92 Barrier rail |
Material Information
| Material Type | Concrete | The concrete mix design number | CM 5645 |
|---|---|---|---|
| The truck number from where the sample was collected | 171 | The batch plant ticket number from where the sample was collected | 878974 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | TRUCK | Where the material sample would have been placed if not sampled | 736 SV at Sunset Ave SW1847 between station 1846 32 to 1846 92 Barrier rail |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2017-09-05-5-1 ASTM C39-17a (Verified)