Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-10-04-5
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 211070 DEA: 080Q3004 EFIS: 0800020191 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-138-R17.1/R19.2 |
| Award Date | 04/18/2016 |
| Closeout Date | 09/28/2020 |
| Work Description | REALIGN SECTION OF STATE ROUTE 138 |
| Location Description | Near Hesperia from 1.9 mi East of Route 15 to 0.1 mi West of Summit Post Office Road to realign sections of State Route 138 |
| QA Service Level | 1 (Verified on 04/27/2016) |
Sample Information
| Sample Taken Date | 10/04/2017 | 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 | 10/11/2017 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylindes |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Eddy | Last name of sampler or witnessed by | SCOTT |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 955-04B | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Robertsons Lucern Valley | Transportation Laboratory (TL) Number | 20171004-B |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Double Drain Creek BridgeUnknown |
| Structure name | Double Drain Creek Bridge |
Material Information
| Material Type | Concrete | The concrete mix design number | RRM16065 |
|---|---|---|---|
| The truck number from where the sample was collected | 1962 | The batch plant ticket number from where the sample was collected | 2872485 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | chute | Where the material sample would have been placed if not sampled | Double Drain Creek Bridge 2nd Deck pour |
| 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. | |||