Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-10-24-1

Project Information

Project IdentifiersProject ID: 215689
DEA: 074W8604
EFIS: 0720000067
DIST-CO-RTE-PM07-LA-605-R10.2/R20.2
Award Date06/08/2021
Closeout Date03/01/2022
Work DescriptionINDIVIDUAL SLAB REPLACEMENT.
Location DescriptionLOS ANGELES COUNTY IN SANTA FE SPRINGS AND BALDWIN PARK FROM TELEGRAPH ROAD UNDERCROSSING TO ROUTE 605/10 SEPARATION
QA Service Level1 (Verified on 08/17/2021)

Sample Information

Sample Taken Date10/24/2021 Sample Unique Key1
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 testing10/24/2021
Sample typeAcceptance A brief description of the samplecasting concrete beams
The quantity of what the sample constitutes250 CY From where was the sample collectedJob Site
First name of sampler or witnessed byNelson Last name of sampler or witnessed byAlvarado
Title of samplerTECivil Telephone number of sampler818-262-8855
Laboratory sample identification21-2644 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCTS SHORT LOAD RAPID SET 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 numberCTS-65-EHI
The truck number from where the sample was collected9 The batch plant ticket number from where the sample was collected333624
Concrete batch plantRte 605 The fabricator/manufacturer designation for the sampleon site batch plant
A detailed description of where the material sample was collectedDischarge chute from back of truck 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
2021-10-24-1-1CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength ConcreteNelson Alvarado, CT D07 - Materials Field Laboratory, Unit 195310/27/2021Nelson Alvarado
No
ISR-RSC Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-10-24-1-1 CTM 524-March 2013