Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-05-12-57
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Project Information
| Project Identifiers | Project ID: 215221 DEA: 07332604 EFIS: 0716000287 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-R12.4/14.9 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | REMOVE RAISED ISLAND, CONSTRUCT CONCRETE BARRIER AND INSTALL LIGHTING. |
| Location Description | THE COUNTY AND CITY OF LOS ANGELES FROM 0.1 MILE EAST OF ARLINGTON AVENUE OVERCROSSING TO 0.7 MILE EAST OF ROUTE 10/110 SEPARATION |
| QA Service Level | 1 (Verified on 03/19/2021) |
Sample Information
| Sample Taken Date | 05/12/2021 | Sample Unique Key | 57 |
|---|---|---|---|
| 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 | 06/14/2021 |
| Sample type | Annual Source Testing | A brief description of the sample | Washed Concrete Sand |
| The quantity of what the sample constitutes | 1 Bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | Chris | Last name of sampler or witnessed by | Hindman |
| Title of sampler | QC Representative | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Robertsons - Cabazon | Transportation Laboratory (TL) Number | 4044 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-33-0008::CABAZON QUARRY |
|---|---|---|---|
| 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 collected | Stockpile | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-05-12-57-6 CTM 202-November 2011 (Verified)
DIME Test ID: 2021-05-12-57-7 CTM 207-March 2012 (Verified)
DIME Test ID: 2021-05-12-57-8 CTM 213-December 2012 (Verified)
DIME Test ID: 2021-05-12-57-9 CTM 217-June 2011 (Verified)
DIME Test ID: 2021-05-12-57-10 CTM 229-June 2011 (Verified)