Sample Record

Owner Lab

  • CT D08 - Fontana Field Testing Laboratory

DIME Sample ID 2019-07-27-2

Project Information

Project IdentifiersProject ID: 213746
DEA: 080Q75U4
EFIS: 0817000114
DIST-CO-RTE-PM08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Award Date04/18/2019
Closeout Date06/28/2022
Work DescriptionREPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location DescriptionNot set
QA Service Level1 (Verified on 06/17/2019)

Sample Information

Sample Taken Date07/27/2019 Sample Unique Key2
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 testing07/27/2019
Sample typeDepartment Acceptance A brief description of the sample1x 4 Pcc Aggregate
The quantity of what the sample constitutes3 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byAhmad Last name of sampler or witnessed byALZUBI
Title of samplerTE Civil Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRV Concrete Inc Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-33-0027::CORONA QUARRY
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 collectedbelt cut
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 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