Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-09-03-23

Project Information

Project IdentifiersProject ID: 215221
DEA: 07332604
EFIS: 0716000287
DIST-CO-RTE-PM07-LA-10-R12.4/14.9
Award Date12/16/2020
Closeout Date11/25/2024
Work DescriptionREMOVE RAISED ISLAND, CONSTRUCT CONCRETE BARRIER AND INSTALL LIGHTING.
Location DescriptionTHE COUNTY AND CITY OF LOS ANGELES FROM 0.1 MILE EAST OF ARLINGTON AVENUE OVERCROSSING TO 0.7 MILE EAST OF ROUTE 10/110 SEPARATION
QA Service Level1 (Verified on 03/19/2021)

Sample Information

Sample Taken Date09/03/2021 Sample Unique Key23
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 testing09/04/2021
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes10CY From where was the sample collectedJob Site
First name of sampler or witnessed byChad Last name of sampler or witnessed byChotibhongs
Title of samplerMREA Telephone number of sampler213-817-0387
Laboratory sample identification21-2137 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRobertson Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameI-10WB between Hoover and Normandie

Material Information

Material TypeConcrete The concrete mix design numberSC270N31
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected6333866
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedDischarge from concrete truck into wheelbarrow. Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-09-03-23-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersChad Chotibhongs, CT D07 - Materials Field Laboratory, Unit 195309/10/2021Chad Chotibhongs
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-09-03-23-1 CTM 521-June 2020