Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2021-07-16-4
Project Information
Project Identifiers | Project ID: 77777 DEA: CHEM-STOCK EFIS: CHEM-STOCK |
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DIST-CO-RTE-PM | 59--- |
Award Date | Not set |
Closeout Date | Not set |
Work Description | Special project for Chem Lab stock material. Object Code: 1025. J2 DEA: 912680. |
Location Description | Not set |
QA Service Level | NOT VERIFIED |
Sample Information
Sample Taken Date | 07/16/2021 | Sample Unique Key | 4 |
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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 testing | 07/16/2021 |
Sample type | Quality Control | A brief description of the sample | Concrete Test Samples |
The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Adriana | Last name of sampler or witnessed by | Ortiz |
Title of sampler | Telephone number of sampler | 3238053068 | |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | universal precast | 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 | 56789 |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 5678743534 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Back of Truck | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |