Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2019-12-17-15
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Project Information
| Project Identifiers | Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 |
|---|---|
| DIST-CO-RTE-PM | 07-LA,ORA-5-0.0/1.5, 44.3/44.4 |
| Award Date | 05/27/2016 |
| Closeout Date | 08/01/2023 |
| Work Description | CONSTRUCT HOV LANES AND MIX FLOW LANES. |
| Location Description | LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK |
| QA Service Level | 1 (Verified on 03/16/2016) |
Sample Information
| Sample Taken Date | 12/17/2019 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 testing | 12/17/2019 |
| Sample type | Department Acceptance | A brief description of the sample | 3/4" LEAN CONCRETE BASE |
| The quantity of what the sample constitutes | 1 | From where was the sample collected | Distributor |
| First name of sampler or witnessed by | TUAN A | Last name of sampler or witnessed by | Nguyen |
| Title of sampler | MREA | Telephone number of sampler | |
| Laboratory sample identification | 9006 | Linked DIME Sample ID | 2019-12-17-15 |
| The fabricator/manufacturer/facility name | SECURITY PAYMENT -LA MERIDA | Transportation Laboratory (TL) Number | C TNTI |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | Unknown |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | SECURITY PAVEMENT LA MIRADA |
| The plant number | Unknown | A detailed description of where the material sample was collected | unknown |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | 3/4 inch |
| The concrete mix design number | G3-17-LCB-004 | Lot number | Unknown |
| Sublot number | Unknown | Aggregate Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-12-17-15-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2019-12-17-15-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2019-12-17-15-3 CTM 226-July 2010 (Verified)