Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-10-07-101

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award Date04/03/2020
Closeout Date06/06/2024
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date10/07/2021 Sample Unique Key101
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 testing10/08/2021
Sample typeDepartment Acceptance A brief description of the sampleJPCP beams
The quantity of what the sample constitutes10CY From where was the sample collectedSource
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 identification21-2563 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFlatiron Plant 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 numberJPCP-3215-06
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected16
Concrete batch plantFlatiron The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedLoader 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
2021-10-07-101-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteChad Chotibhongs, CT D07 - Materials Field Laboratory, Unit 195311/04/2021Chad Chotibhongs
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-10-07-101-1 CTM 523-May 2020