Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2020-09-17-9

Project Information

Project IdentifiersProject ID: 208973
DEA: 120H1004
EFIS: 1200000180
COOP: 120670
DIST-CO-RTE-PM12-ORA-405,73,405,605-9.3/24.3
Award Date11/07/2016
Closeout DateNot set
Work Description(Alternative Delivery) San Diego Freeway (I-405) Improvement Project SR-73 to I-605, Design Build Project, Administered by Orange County Transportation Authority, Caltrans METS to perform Source Inspection per RFP.
Location DescriptionOrange and Los Angeles Counties: 12-ORA-405 PM 9.3/24.2 / 07-LA-405 PM 0.0/1.2 12-ORA-22 PM R0.7/R3.8 / 12-ORA-22 PM R0.5/R0.7 12-ORA-73 PM R27.2/R27.8 / 12-ORA-605 PM 3.5/R1.6 07-LA-605 PM R0.0/R1.2
QA Service Level1 (Verified on 09/10/2015)

Sample Information

Sample Taken Date09/17/2020 Sample Unique Key9
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 testing09/21/2020
Sample typeVerification A brief description of the sampleConcrete Cylinders for 28-Day testing
The quantity of what the sample constitutes2 6x12 concrete cylinders From where was the sample collectedSource
First name of sampler or witnessed byRamsey Last name of sampler or witnessed byDoumani
Title of samplerQA Inspector Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCoreslab Structures Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameSanta Ana River Bridge Girders

Material Information

Material TypeConcrete The concrete mix design number312
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected76396
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSample was collected from middle of concrete batch for truck 2 of continuous pour Where the material sample would have been placed if not sampledplaced in concrete girder
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.