Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-04-25-4

Project Information

Project IdentifiersProject ID: 212645
DEA: 080N9714
EFIS: 0815000101
DIST-CO-RTE-PM08-SBD-395-39.0/45.9
Award Date11/07/2017
Closeout Date12/12/2019
Work DescriptionWIDEN EXISTING SHOULDERS TO 8' AND CONSTRUCT 4' MEDIAN BUFFER
Location DescriptionSAN BERNARDINO COUNTY NEAR ADELANTO FROM 2.2 MILES NORTH OF KRAMER ROAD TO ROUTE 58
QA Service Level1 (Verified on 04/04/2018)

Sample Information

Sample Taken Date04/25/2019 Sample Unique Key4
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 testing04/29/2019
Sample typeVerification A brief description of the sample1/2 RHMA-G-SP
The quantity of what the sample constitutesJMF 6 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byBlue Diamond Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identification0250G-19 Linked DIME Sample ID
The fabricator/manufacturer/facility nameORO GRANDE, WHITE MOUNTAIN 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)91-36-0046, 91-36-0106
The fabricator's/manufacturer's product name for the sample1/2 RHMA-G-SP The fabricator/manufacturer designation for the sample300191-LSM
The plant numberUnknown A detailed description of where the material sample was collectedBelt Cut at Plant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1/2 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown JMF Verification ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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