Sample Record

Owner Lab

  • Con-Fab California, LLC

DIME Sample ID 2020-07-07-1

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date07/07/2020 Sample Unique Key1
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 testing07/08/2020
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes12 From where was the sample collectedFabricator
First name of sampler or witnessed byTrevor Last name of sampler or witnessed byLaws
Title of samplerQC Manager Telephone number of sampler
Laboratory sample identificationSultana 7-7-20 Linked DIME Sample ID
The fabricator/manufacturer/facility nameConfab Shafter Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameSultana Bridge OC

Material Information

Material TypeConcrete The concrete mix design numberSCC-S9_8-10F
The truck number from where the sample was collected3 The batch plant ticket number from where the sample was collected1976
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedBack of Truck 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.