Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2018-06-21-17

Project Information

Project IdentifiersProject ID: 209695
DEA: 08347704
EFIS: 0800000616
DIST-CO-RTE-PM08-SBD-SR-58-0/12.9
Award Date11/10/2017
Closeout Date01/14/2021
Work Description(Alternative Delivery) The CMGC project will upgrade SR 58 from 2- to 4-lanes in San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Location DescriptionSR-58 / 395 Kramer Junction project. In San Bernardino County from the Kern County line to 7.5 miles east of US-395.
QA Service Level1 (Verified on 12/01/2017)

Sample Information

Sample Taken Date06/21/2018 Sample Unique Key17
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 testing06/25/2018
Sample typeQuality Assurance A brief description of the sampleconcrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byAbdul Last name of sampler or witnessed byHakeem Al Shukaili
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification976-621 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRobertsons Transportation Laboratory (TL) Number20180621
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier54 1325L
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberSM446B38
The truck number from where the sample was collected1217 The batch plant ticket number from where the sample was collected3331910
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedsite Where the material sample would have been placed if not sampledBent 4 L Column
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