Sample Record

Owner Lab

  • CT D08 - Fontana Field Testing Laboratory

DIME Sample ID 2019-06-05-14

Project Information

Project IdentifiersProject ID: 209694
DEA: 080J0704
EFIS: 0800000282
DIST-CO-RTE-PM08-SBD-215-0.6/1.7
Award Date10/17/2017
Closeout Date04/23/2020
Work Description(Alternative Delivery) The CMGC project will reconstruct and improve interchange of I-215 and Barton Road in the City of Grand Terrace, CA.
Location DescriptionGrade separation at Intersection of I-215 and Barton Road near Grand Terrace, CA. ? On I-215 between I-10 and SR-60.
QA Service Level1 (Verified on 12/11/2017)

Sample Information

Sample Taken Date06/05/2019 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 testing06/18/2019
Sample typeAcceptance A brief description of the sampleConcrete beams
The quantity of what the sample constitutes6 Beams From where was the sample collectedJob Site
First name of sampler or witnessed byHamid Last name of sampler or witnessed byArjamond
Title of sampler Telephone number of sampler
Laboratory sample identification20A1,20A2, 20B1, 20B2, 20C1,20C2 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRobertson Riverside Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier42-xxxx
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberSC675B38
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedTT1
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedon jobsite at concrete truck 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.