Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-06-25-9

Project Information

Project IdentifiersProject ID: 209695
DEA: 08347704
EFIS: 0800000616
DIST-CO-RTE-PM08-SBD-SR-58-0/12.9
Award Date11/10/2017
Closeout Date01/14/2021
Work Description(Alternative Delivery) The CMGC project will upgrade SR 58 from 2- to 4-lanes in San Bernardino County from the Kern County line to 7.5 miles east of US-395.
Location DescriptionSR-58 / 395 Kramer Junction project. In San Bernardino County from the Kern County line to 7.5 miles east of US-395.
QA Service Level1 (Verified on 12/01/2017)

Sample Information

Sample Taken Date06/25/2019 Sample Unique Key9
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 testing06/27/2019
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byKenedy Last name of sampler or witnessed byoluoha
Title of samplerLab Technician Telephone number of sampler
Laboratory sample identification976-6259 Linked DIME Sample ID
The fabricator/manufacturer/facility nameKiewitt Plant Transportation Laboratory (TL) Number01-6252019
Inspector Lot Number from the Transportation Laboratory (TL) Form130cy Structure unique identifier
Structure name130cy

Material Information

Material TypeConcrete The concrete mix design numberLB18-0031
The truck number from where the sample was collected19901 The batch plant ticket number from where the sample was collectedUnknown
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleKIEWITT
A detailed description of where the material sample was collected130 cy 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 Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments