Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-04-02-18

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 214671
DEA: 07303904
EFIS: 0714000044
DIST-CO-RTE-PM07-LA-10-31.2/37.2
Award Date11/25/2020
Closeout DateNot set
Work DescriptionLANE REPLACEMENT
Location DescriptionLOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
QA Service Level1 (Verified on 01/21/2021)

Sample Information

Sample Taken Date04/02/2021 Sample Unique Key18
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 testing04/16/2021
Sample typeQuality Assurance A brief description of the sampleRapid Setting Concrete
The quantity of what the sample constitutes2 Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byJay Last name of sampler or witnessed byWest
Title of samplerQuality Specialist Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCTS Cement Transportation Laboratory (TL) NumberC029
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeRapid Set ManufacturerCTS Cement Manufacturing Corporation
Mix no.3513 Materials ReceivedRapid Set DOT Repair Mix
Lot no.23104091 Batch no.23104091

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-04-02-18-1CONCLP 2-16: Rapid Set Patching MaterialsMike MullinsCT HQ - Sacramento Concrete Testing Laboratory04/22/2021Spencer Adams
Yes
04/22/2021