Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2020-11-09-25
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Project Information
| Project Identifiers | Project ID: 214543 DEA: 080K8404 EFIS: 0800020563 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-L5726- |
| Award Date | 01/09/2020 |
| Closeout Date | 04/28/2022 |
| Work Description | MAINTENANCE STATION BUILDING WORK. |
| Location Description | SAN BERNARDINO AT THE SAN BERNARDINO MAINTENANCE STATION AT 175 WEST CLUSTER STREET |
| QA Service Level | 1 (Verified on 02/26/2020) |
Sample Information
| Sample Taken Date | 11/09/2020 | Sample Unique Key | 25 |
|---|---|---|---|
| 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 | 11/23/2020 |
| Sample type | Quality Assurance | A brief description of the sample | Concrete Cylinders |
| The quantity of what the sample constitutes | 3 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Fuad | Last name of sampler or witnessed by | Modiri |
| Title of sampler | ASR | Telephone number of sampler | |
| Laboratory sample identification | 1020-119 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertsons | Transportation Laboratory (TL) Number | 1 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SM445B37 |
|---|---|---|---|
| The truck number from where the sample was collected | 1796 | The batch plant ticket number from where the sample was collected | 5844371 |
| Concrete batch plant | ROBERTSONS | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | LINE PUMP | Where the material sample would have been placed if not sampled | SHOP 8 BUILDING FOOTINGS |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-11-09-25-1 ASTM C39-17a (Verified)