Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2018-01-25-6

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 Date01/18/2022
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 Date01/25/2018 Sample Unique Key6
Date that the sample was received by the laboratory/organization performing the testing02/05/2018 Sample typeQuality Control
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 byAHMAD
Last name of sampler or witnessed byANKIR Title of samplerUnknown
Telephone number of samplerUnknown Laboratory sample identification934-25
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameROBERTSONS
Transportation Laboratory (TL) Number1 Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierBR FTG AT BENT 3 WIDENING Structure nameUnknown
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberSC675B38
The truck number from where the sample was collected1911 The batch plant ticket number from where the sample was collected3321497
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedLOAD 1 Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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