Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2018-06-11-10

Project Information

Project IdentifiersProject ID: 209694
DEA: 080J0704
EFIS: 0800000282
DIST-CO-RTE-PM08-SBD-215-0.6/1.7
Award Date10/17/2017
Closeout Date04/23/2020
Work Description(Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location DescriptionGrade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
QA Service Level1 (Verified on 12/11/2017)

Sample Information

Sample Taken Date06/11/2018 Sample Unique Key10
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 testing06/18/2018
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
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 identification975-611 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameROBERTSON Transportation Laboratory (TL) Number975-611
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierABUTMENT 4 RIGHT RETANING WALL
Structure nameABUTMENT 4 RIGHT RETANING WALL

Material Information

Material TypeConcrete The concrete mix design numberSC590B38
The truck number from where the sample was collected142 The batch plant ticket number from where the sample was collected3592864
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleMYERS
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampledABUTMENT 4 RIGHT RETANING WALL
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