Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2021-07-16-4

Project Information

Project IdentifiersProject ID: 77777
DEA: STOCK-CHEM
EFIS: STOCK-CHEM
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date07/16/2021 Sample Unique Key4
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing07/16/2021
Sample typeQuality Control A brief description of the sampleConcrete Test Samples
The quantity of what the sample constitutes2 From where was the sample collectedFabricator
First name of sampler or witnessed byAdriana Last name of sampler or witnessed byOrtiz
Title of sampler Telephone number of sampler3238053068
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameuniversal precast Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number56789
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected5678743534
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBack of Truck Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.