Sample Record

Owner Lab

  • CT D08 - Hesperia Field Testing Laboratory

DIME Sample ID 2020-10-25-6

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 Date10/25/2020 Sample Unique Key6
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 testing11/25/2020
Sample typeAcceptance A brief description of the sampleMixed aggregates
The quantity of what the sample constitutes2 bahgs From where was the sample collectedManufacturer
First name of sampler or witnessed byRAMY Last name of sampler or witnessed byMekail
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)Cemex
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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