Sample Record
Owner Labs
- CT HQ - QASI Los Angeles Field Office
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2020-07-06-11
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Project Information
| Project Identifiers | Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-10-0.0/13.2 |
| Award Date | 06/06/2018 |
| Closeout Date | Not set |
| Work Description | Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes |
| Location Description | LA/SBD County Line to PM 13.2 near I-15 |
| QA Service Level | 1 (Verified on 10/16/2019) |
Sample Information
| Sample Taken Date | 07/06/2020 | Sample Unique Key | 11 |
|---|---|---|---|
| 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 | 07/09/2020 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Grey |
| Title of sampler | QA Inspector | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Confab Shafter | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 54-0444 | |
| Structure name | Sultana Bridge OC |
Material Information
| Material Type | Concrete | The concrete mix design number | SCC-S9_8-10F |
|---|---|---|---|
| The truck number from where the sample was collected | Unknown | The batch plant ticket number from where the sample was collected | 2172 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | tailgate | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-07-06-11-1 ASTM C39-17a (Verified)