Sample Record

Owner Lab

  • CT D07 - Material Lab, Unit 1953

DIME Sample ID 2021-11-13-11

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout DateNot set
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date11/13/2021 Sample Unique Key11
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 testing11/13/2021
Sample typeAcceptance A brief description of the sampleBurbank blvd
The quantity of what the sample constitutes300 cy From where was the sample collectedJob Site
First name of sampler or witnessed bySopheak Last name of sampler or witnessed byChong
Title of samplerTE Telephone number of sampler12138170174
Laboratory sample identification21-2795 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving Transportation Laboratory (TL) Number21-2795
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier21-2795
Structure nameSopheak Chong

Material Information

Material TypeConcrete The concrete mix design numberSecurity Paving
The truck number from where the sample was collected3 The batch plant ticket number from where the sample was collected225645
Concrete batch plantSecurity Paving batch plant The fabricator/manufacturer designation for the sampleSecurity Paving
A detailed description of where the material sample was collectedBurbank Blvd Where the material sample would have been placed if not sampledJobsite
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-13-11-1CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete CylindersSopheak ChongCT D07 - Material Lab, Unit 195311/20/2021Sopheak Chong
No
Info