Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2021-11-30-8

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award DateNot set
Closeout DateNot set
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 Date11/30/2021 Sample Unique Key8
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing12/01/2021
Sample typeAcceptance A brief description of the sample1 in
The quantity of what the sample constitutes100 cy From where was the sample collectedFabricator
First name of sampler or witnessed byVictor Last name of sampler or witnessed byPham
Title of samplerTET Telephone number of sampler2137924794
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameAssociate Ready mixed Concrete Transportation Laboratory (TL) Number113021
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-19-0025::IRWINDALE
The fabricator's/manufacturer's product name for the sample590lbs concrete The fabricator/manufacturer designation for the sample3600 psi
The plant numberSun Valley A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampledRW Primary Aggregate Nominal Size1 inch
The concrete mix design number556300 Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-30-8-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesVictor PhamCT D07 - Plant Services11/30/2021Victor Pham
Yes
05/04/2022

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2021-11-30-8-1 CTM 202-November 2011 (Verified)