Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2019-12-19-23

Sample is locked from editing. info

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 Date12/19/2019 Sample Unique Key23
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 testing12/23/2019
Sample typeAcceptance A brief description of the sample3/8" PCC AGG
The quantity of what the sample constitutes1 BUCKET From where was the sample collectedDistributor
First name of sampler or witnessed byMD Last name of sampler or witnessed byShahjahan
Title of samplerMREA Telephone number of sampler
Laboratory sample identification9055 Linked DIME Sample ID2019-12-19-23
The fabricator/manufacturer/facility nameVULCAN SUN VALLEY Transportation Laboratory (TL) NumberC914342
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 numberS72017 Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-12-19-23-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesLARRY DIAZCT - Southern Regional Laboratory12/30/2019Jose Mendez
Yes
03/13/2020
2019-12-19-23-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)HUSNI ANKIRCT - Southern Regional Laboratory12/30/2019Jose Mendez
Yes
03/13/2020