Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2017-12-18-15

Project Information

Project IdentifiersProject ID: 210569
DEA: 083555V4
EFIS: 0814000086
DIST-CO-RTE-PM08-SBD-15-42.5/46.0
Award Date11/05/2015
Closeout DateNot set
Work DescriptionWIDEN I-15, RECONSTRUCT 3 IC'S, CONSTRUCT 2 NEW BR AND WIDEN 3 BR.
Location DescriptionSAN BERNARDINO COUNTY IN VICTORVILLE FROM 0.5 MILE NORTH OF MOJAVE DRIVE TO 1.5 MILE NORTH OF STODDARD WELLS ROAD OVERCROSSING
QA Service Level1 (Verified on 10/15/2015)

Sample Information

Sample Taken Date12/18/2017 Sample Unique Key15
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 testing12/20/2017
Sample typeQuality Assurance A brief description of the sample6X12
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byRAVINDER Last name of sampler or witnessed bySINGH
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identification934-218 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameROBERTSONS Transportation Laboratory (TL) Number20171218
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierBent cap 5 at victorville oh widen and new
Structure nameBent cap 5 at victorville oh widen and new

Material Information

Material TypeConcrete The concrete mix design numberSC675B38
The truck number from where the sample was collectedNP The batch plant ticket number from where the sample was collectedNP
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedBent cap 5 at victorville oh widen and new Where the material sample would have been placed if not sampledBent cap 5 at victorville oh widen and new
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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