Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-09-07-6

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
Location DescriptionNot set
QA Service Level1 (Verified on 06/17/2019)

Sample Information

Sample Taken Date09/07/2019 Sample Unique Key6
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 testing09/09/2019
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byIvan Last name of sampler or witnessed byLopez
Title of samplerRMA Field test Telephone number of sampler
Laboratory sample identification999-907D Linked DIME Sample ID
The fabricator/manufacturer/facility nameShort Load Concrete Transportation Laboratory (TL) Number907D
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameEB RTE 60 Lane 2 WEST of Market ST 5250 ft

Material Information

Material TypeConcrete The concrete mix design numberCMAX 30 RAM
The truck number from where the sample was collectedNA The batch plant ticket number from where the sample was collectedna
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleJMECI
A detailed description of where the material sample was collectedSET 4 Where the material sample would have been placed if not sampledEB RTE 60 Lane 2 WESTof Market ST 5250 ft
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