Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-04-04-14

Project Information

Project IdentifiersProject ID: 210735
DEA: 071193U4
EFIS: 0713000007
DIST-CO-RTE-PM07-LA-10-37.2/42.4
Award Date11/16/2015
Closeout Date07/11/2022
Work DescriptionCONSTRUCT HOV LANES, WIDEN BRIDGES, AND REALIGN RAMPS.
Location DescriptionIN LA COUNTY FROM CITRUS STREET IN WEST COVINA TO ROUTE 57 IN POMONA
QA Service Level1 (Verified on 03/07/2016)

Sample Information

Sample Taken Date04/04/2019 Sample Unique Key14
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 testing04/08/2019
Sample typeAnnual Source Testing A brief description of the sample1.0" PCC Aggregates
The quantity of what the sample constitutes5 Bags From where was the sample collectedSource
First name of sampler or witnessed byKameron Last name of sampler or witnessed byMoinian
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility name91-36-0006 Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberunknown
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected703414
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedStockpile 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.