Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2021-10-24-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215689 DEA: 074W8604 EFIS: 0720000067 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-605-R10.2/R20.2 |
| Award Date | 06/08/2021 |
| Closeout Date | 03/01/2022 |
| Work Description | INDIVIDUAL SLAB REPLACEMENT. |
| Location Description | LOS ANGELES COUNTY IN SANTA FE SPRINGS AND BALDWIN PARK FROM TELEGRAPH ROAD UNDERCROSSING TO ROUTE 605/10 SEPARATION |
| QA Service Level | 1 (Verified on 08/17/2021) |
Sample Information
| Sample Taken Date | 10/24/2021 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 10/24/2021 |
| Sample type | Department Acceptance | A brief description of the sample | casting concrete beams |
| The quantity of what the sample constitutes | 250 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Nelson | Last name of sampler or witnessed by | Alvarado |
| Title of sampler | TECivil | Telephone number of sampler | 818-262-8855 |
| Laboratory sample identification | 21-2644 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | CTS 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 Type | Concrete | The concrete mix design number | CTS-65-EHI |
|---|---|---|---|
| The truck number from where the sample was collected | 9 | The batch plant ticket number from where the sample was collected | 333624 |
| Concrete batch plant | Rte 605 | The fabricator/manufacturer designation for the sample | on site batch plant |
| A detailed description of where the material sample was collected | Discharge 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 ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| 2021-10-24-1-1 | CTM 524-March 2013: Method of Test for Flexural Strength Of Rapid Strength Concrete | Nelson Alvarado, CT D07 - Materials Field Laboratory, Unit 1953 | 10/27/2021 | Nelson Alvarado | No | ISR-RSC | Info |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-10-24-1-1 CTM 524-March 2013