Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2018-01-25-7

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 Key7
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 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 identification934-17 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameROBERTSONS Transportation Laboratory (TL) Number1
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierBENT CAP AT PEIR WALL 4 WIDEN
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberSC675B38
The truck number from where the sample was collected1207 The batch plant ticket number from where the sample was collected3321287
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

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

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Test File Attachments