Sample Record

Owner Lab

  • CT D08 - Barstow Field Testing Laboratory

DIME Sample ID 2020-12-30-12

Project Information

Project IdentifiersProject ID: 213970
DEA: 080K1214
EFIS: 0815000245
DIST-CO-RTE-PM08-SBD-15-12.5/14.8
Award Date12/23/2019
Closeout DateNot set
Work DescriptionREPLACE PCC PAVEMENT WITH JPCP AND PRECAST JOINTED CONCRETE PAVEMENT.
Location DescriptionSAN BERNARDINO COUNTY IN FONTANA AND NEAR DEVORE FROM 0.3 MILE SOUTH OF SIERRA AVENUE UNDERCROSSING TO GLEN HELEN PARKWAY UNDERCROSSING
QA Service Level1 (Verified on 12/12/2019)

Sample Information

Sample Taken Date12/30/2020 Sample Unique Key12
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 testing12/31/2020
Sample typeQuality Assurance A brief description of the sampleConcrete beams
The quantity of what the sample constitutes4 From where was the sample collectedJob Site
First name of sampler or witnessed byLarry Last name of sampler or witnessed byFrancisco
Title of samplerte Telephone number of sampler
Laboratory sample identification29 Linked DIME Sample ID
The fabricator/manufacturer/facility namecemex 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 numberLB0600AB
The truck number from where the sample was collectedtruck The batch plant ticket number from where the sample was collected5931835
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedfrom mix 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.