Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-08-10-25

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award DateNot set
Closeout DateNot set
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date08/10/2021 Sample Unique Key25
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 testing08/11/2021
Sample typeQuality Assurance A brief description of the sampleJPCP beams
The quantity of what the sample constitutes10CY From where was the sample collectedSource
First name of sampler or witnessed byChad Last name of sampler or witnessed byChotibhongs
Title of samplerMREA Telephone number of sampler(213)817-0387
Laboratory sample identification21-1993 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFlatiron Plant 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 numberJPCP-3215-06
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected23
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBobcat on site 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
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Sample File Attachments

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Test File Attachments