Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-09-28-46

Project Information

Project IdentifiersProject ID: 214671
DEA: 07303904
EFIS: 0714000044
DIST-CO-RTE-PM07-LA-10-31.2/37.2
Award Date11/25/2020
Closeout Date10/11/2023
Work DescriptionLANE REPLACEMENT
Location DescriptionLOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
QA Service Level1 (Verified on 01/21/2021)

Sample Information

Sample Taken Date09/28/2021 Sample Unique Key46
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 testing10/29/2021
Sample typeAcceptance A brief description of the sampleJPCPRS
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 identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNA 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 numberNA
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedNA
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedDischarge from 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
2021-09-28-46-1CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength ConcreteChad Chotibhongs, CT D07 - Materials Field Laboratory, Unit 195310/08/2021Chad Chotibhongs
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-09-28-46-1 CTM 524-March 2013