Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2021-10-30-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214524 DEA: 07304504 EFIS: 0714000067 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-57-R0.0/R4.5 |
| Award Date | 06/11/2020 |
| Closeout Date | Not set |
| Work Description | CONCRETE PAVEMENT, CONCRETE BARRIER, AND ELECTRICAL WORK. |
| Location Description | LOS ANGELES COUNTY IN DIAMOND BAR AND CITY OF INDUSTRY FROM ORANGE COUNTY LINE TO ROUTE 57/60 SEPARATION |
| QA Service Level | 1 (Verified on 08/12/2020) |
Sample Information
| Sample Taken Date | 10/30/2021 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 | 11/06/2021 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 LCB cylinders |
| The quantity of what the sample constitutes | 10 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Rosauro | Last name of sampler or witnessed by | Nogoy |
| Title of sampler | TE Civil | Telephone number of sampler | 2137939321 |
| Laboratory sample identification | 21-2680 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Vanguard | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | NB 57 outer shoulder |
Material Information
| Material Type | Concrete | The concrete mix design number | 57030SL |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 3 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Discharge from concrete truck into wheelbarrow. | Where the material sample would have been placed if not sampled | Sta 139 plus 97 |
| 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 |
|---|---|---|---|---|---|---|---|---|
| 2021-10-30-3-1 | CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete Cylinders | Rosauro Nogoy, CT D07 - Materials Field Laboratory, Unit 1953 | 11/06/2021 | Rosauro Nogoy | No | Info |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-10-30-3-1 CTM 521-June 2020