Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2019-12-13-17

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 213976
DEA: 073W8804
EFIS: 0717000127
DIST-CO-RTE-PM07-LA-1-56.9/62.9
Award Date04/22/2019
Closeout Date11/02/2020
Work DescriptionAPPLY SLURRY SEAL AND REPLACE AC SURFACING.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM TRANCAS CANYON ROAD/BROAD BEACH ROAD TO THE VENTURA COUNTY LINE
QA Service Level1 (Verified on 11/02/2020)

Sample Information

Sample Taken Date12/13/2019 Sample Unique Key17
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 testing12/18/2019
Sample typeAcceptance A brief description of the sampleAggregate Type III for Slurry Seal
The quantity of what the sample constitutes1 Bags From where was the sample collectedJob Site
First name of sampler or witnessed bykevin Last name of sampler or witnessed byHOPPKINS
Title of samplerMREA Telephone number of sampler
Laboratory sample identification9036 Linked DIME Sample ID
The fabricator/manufacturer/facility nameUnknown Transportation Laboratory (TL) NumberC914681
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)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 collectedSTOCKPILE @ JOBSITE
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Sizefine
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-12-13-17-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesEDMOUND JABBOUR, CT D08 - Fontana Southern Regional Laboratory12/26/2019Jose Mendez
Yes
03/13/2020
2019-12-13-17-2CTM 217-June 2011: Method of Test for Sand EquivalentLARRY DIAZ, CT D08 - Fontana Southern Regional Laboratory12/30/2019Jose Mendez
Yes
03/13/2020
2019-12-13-17-3CTM 226-July 2010: Method of Test for Determination of Moisture Content of Soils and Aggregates by Oven DryingEDMOUND JABBOUR, CT D08 - Fontana Southern Regional Laboratory12/26/2019Jose Mendez
Yes
03/13/2020

Sample File Attachments

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Test File Attachments


DIME Test ID: 2019-12-13-17-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2019-12-13-17-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2019-12-13-17-3 CTM 226-July 2010 (Verified)