Sample Record
Owner Lab
- CT D08 - Fontana Field Testing Laboratory
DIME Sample ID 2020-05-28-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214221 DEA: 081F1424 EFIS: 0815000232 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-15-23.9/33.4 |
| Award Date | 09/05/2019 |
| Closeout Date | 03/01/2022 |
| Work Description | REPLACE INDIVIDUAL PCC SLABS, GRIND PCC PAVEMENT AND UPGRADE GUARDRAIL |
| Location Description | RIVERSIDE COUNTY NEAR LAKE ELSINORE FROM NICHOLS ROAD OVERCROSSING TO 0.2 MILE NORTH OF TEMESCAL CANYON ROAD UNDERCROSSING |
| QA Service Level | 1 (Verified on 12/04/2019) |
Sample Information
| Sample Taken Date | 05/28/2020 | Sample Unique Key | 20 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 05/29/2020 |
| Sample type | Quality Assurance | A brief description of the sample | PCC Rapid set beams |
| The quantity of what the sample constitutes | 3 beams | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | RMA QC | Last name of sampler or witnessed by | RMA QC |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 8 ISR-A, 8 ISR-B, 8 ISR-C | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | MSC Plant 1 | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 900-5HE |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | TT | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | concrete sample from wheel barrow | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||