Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2020-02-10-5

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date02/10/2020 Sample Unique Key5
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 testing02/10/2020
Sample typeQuality Assurance A brief description of the sample6"x12" cylinder
The quantity of what the sample constitutes3 From where was the sample collectedSource
First name of sampler or witnessed byFrederic Last name of sampler or witnessed byAboujaoude
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCoreslab Structures Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number284
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected74644
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCasting BED 9 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.