Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2017-12-28-2

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date12/28/2017 Sample Unique Key2
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 testing12/29/2017
Sample typeQuality Control A brief description of the sample6x12
The quantity of what the sample constitutes4 From where was the sample collectedJob Site
First name of sampler or witnessed byGARY Last name of sampler or witnessed byMACOMB
Title of samplerASI Telephone number of samplerUnknown
Laboratory sample identification866-917 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameAA Transportation Laboratory (TL) NumberL10-109-17
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierPANEL C3 F 518
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberSFI-LWSBS5
The truck number from where the sample was collected432 The batch plant ticket number from where the sample was collected421544
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments