Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-04-17-17

Project Information

Project IdentifiersProject ID: 210837
DEA: 080J0804
EFIS: 0800000283
COOP: 081625
DIST-CO-RTE-PM08-RIV-15-34.7/51.6
Award Date04/17/2017
Closeout DateNot set
Work Description(Alternative Delivery) DESIGN-BUILD OF THE INTERSTATE 15 EXPRESS LANES PROJECT
Location DescriptionRiverside County and SBD-15-0.0/1.3
QA Service Level1 (Verified on 05/08/2017)

Sample Information

Sample Taken Date04/17/2019 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 testing04/17/2019
Sample typePer Request A brief description of the sampleAggregate Subbase Recycled Asphalt
The quantity of what the sample constitutes1 bag From where was the sample collectedJob Site
First name of sampler or witnessed byAri Last name of sampler or witnessed byKhasraw
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCaltrans 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, name of Pit or Job Site)Unknown
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 collectedI-15
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown Aggregate Mix NumberNot set

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