Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-08-27-23
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Project Information
| Project Identifiers | Project ID: 215350 DEA: 081E0604 EFIS: 0813000140 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-18-97.0/99.5 |
| Award Date | 02/23/2021 |
| Closeout Date | 01/23/2023 |
| Work Description | WIDEN ROADWAY WITH HMA, MINOR CONCRETE & MODIFY SIGNAL & LIGHTING. |
| Location Description | SAN BERNARDINO COUNTY IN VICTORVILLE FROM AMARGOSA ROAD TO COBALT ROAD |
| QA Service Level | 1 (Verified on 06/23/2021) |
Sample Information
| Sample Taken Date | 08/27/2021 | Sample Unique Key | 23 |
|---|---|---|---|
| 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 | 09/03/2021 |
| Sample type | Quality Assurance | A brief description of the sample | concrete cylinders |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Larry | Last name of sampler or witnessed by | Francisco |
| Title of sampler | TE | Telephone number of sampler | |
| Laboratory sample identification | 1031-827 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Not Provided | Transportation Laboratory (TL) Number | 1031-827 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | CT675F25 |
|---|---|---|---|
| The truck number from where the sample was collected | Not Provided on TL | The batch plant ticket number from where the sample was collected | Not Provided |
| Concrete batch plant | Not Provided | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | site | Where the material sample would have been placed if not sampled | Sta 56000 DS7 South Side Palmdale Road |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-08-27-23-1 ASTM C39-18 (Verified)