Sample Record

Owner Lab

  • CT D07 - Material Lab, Unit 1953

DIME Sample ID 2021-11-05-20

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout DateNot set
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date11/05/2021 Sample Unique Key20
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 testing11/06/2021
Sample typeQuality Assurance A brief description of the sample6x12 LCB cylinders
The quantity of what the sample constitutes 10 CY From where was the sample collectedJob Site
First name of sampler or witnessed byRosauro Last name of sampler or witnessed byNogoy
Title of samplerTE Civil Telephone number of sampler2137939321
Laboratory sample identification21-2719 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving 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 numberG317LCB004
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected1
Concrete batch plantSecurity Paving The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedDischarge from concrete truck Where the material sample would have been placed if not sampledNB 5 HOV Lane Sta 21 plus 30
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-05-20-1CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete CylindersRosauro NogoyCT D07 - Material Lab, Unit 195311/12/2021Rosauro Nogoy
No
Info
2021-11-05-20-2CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersRosauro NogoyCT D07 - Material Lab, Unit 195311/12/2021Rosauro Nogoy
No
Info