Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-03-22-1

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 DateNot set
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 Date03/22/2019 Sample Unique Key1
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 testing03/19/2019
Sample typeAggregate Prequalification Program A brief description of the sample1" Max
The quantity of what the sample constitutes500 From where was the sample collectedSource
First name of sampler or witnessed bycfc Last name of sampler or witnessed byxyz
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameabc Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-19-0021
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedPlant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.