Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-11-17-9

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout DateNot set
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date11/17/2019 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 testing11/23/2019
Sample typeAcceptance A brief description of the sample3/8" PCC AGGREGATE
The quantity of what the sample constitutes2 BAGS From where was the sample collectedFabricator
First name of sampler or witnessed byTUAN Last name of sampler or witnessed byNGOYS
Title of samplerMREA Telephone number of sampler
Laboratory sample identification8906 Linked DIME Sample ID2019-11-17-9
The fabricator/manufacturer/facility nameSECURITY PAVEMENT PORTABLE PLANT Transportation Laboratory (TL) NumberC915159
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)Unknown
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 collectedunknown
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberGS-18-PRS Lot numberUnknown
Sublot numberUnknown Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-11-17-9-1CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)HUSNI ANKIRCT D08 - Fontana Southern Regional Laboratory11/26/2019Jose Mendez
No
Info

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2019-11-17-9-1 CTM 227-December 2014