Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-03-11-7
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Project Information
| Project Identifiers | Project ID: 214523 DEA: 07302504 EFIS: 0713000479 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-23-R3.3/R11.5 |
| Award Date | 02/06/2020 |
| Closeout Date | Not set |
| Work Description | PLACE HMA AND JPCP AND INDIVIDUAL SLAB REPLACEMENT. |
| Location Description | VENTURA COUNTY FROM ROUTE 101/23 SEPARATION TO NEW LOS ANGELES AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 03/17/2020) |
Sample Information
| Sample Taken Date | 03/11/2021 | Sample Unique Key | 7 |
|---|---|---|---|
| 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 | 03/18/2021 |
| Sample type | Quality Assurance | A brief description of the sample | concrete cylinders |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Rivera | Last name of sampler or witnessed by | Pantaleon |
| Title of sampler | SR | Telephone number of sampler | |
| Laboratory sample identification | 1025-002 | Linked DIME Sample ID | 002 |
| The fabricator/manufacturer/facility name | Cemex | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 1610837 |
|---|---|---|---|
| The truck number from where the sample was collected | NA | The batch plant ticket number from where the sample was collected | NA |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | 23 SB GORE area - walls | Where the material sample would have been placed if not sampled | |
| 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: 2021-03-11-7-1 ASTM C39-17a (Verified)
DIME Test ID: 2021-03-11-7-2 ASTM C39-17a (Verified)