Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2017-12-08-5

Project Information

Project IdentifiersProject ID: 211070
DEA: 080Q3004
EFIS: 0800020191
DIST-CO-RTE-PM08-SBD-138-R17.1/R19.2
Award Date04/18/2016
Closeout Date09/28/2020
Work DescriptionREALIGN SECTION OF STATE ROUTE 138
Location DescriptionNear 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 Level1 (Verified on 04/27/2016)

Sample Information

Sample Taken Date12/08/2017 Sample Unique Key5
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 testing12/14/2017
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylindes
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byEDDY Last name of sampler or witnessed bySCOTT
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification955-208B Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRobertsons Lucerne Valley Transportation Laboratory (TL) Number20171208B
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierMINER SHACK APPROACH SLABS 1 AND 3 STATION 89 PLUS 109PLUS 15
Structure nameMINER SHACK APPROACH SLABS 1 AND 3 STATION 89 PLUS 109PLUS 15

Material Information

Material TypeConcrete The concrete mix design numberRRM09013
The truck number from where the sample was collected1707 The batch plant ticket number from where the sample was collected3118722
Concrete batch plantRobertsons Batch Plant Lucerne The fabricator/manufacturer designation for the sampleRobertsons Batch Plant Lucerne
A detailed description of where the material sample was collectedchute Where the material sample would have been placed if not sampledAPPROACH SLAB 3
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.