Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-12-17-6
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 |
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DIST-CO-RTE-PM | 08-SBD-10-0.0/13.2 |
Award Date | 06/06/2018 |
Closeout Date | Not set |
Work Description | Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes |
Location Description | LA/SBD County Line to PM 13.2 near I-15 |
QA Service Level | 1 (Verified on 10/16/2019) |
Sample Information
Sample Taken Date | 12/17/2021 | Sample Unique Key | 6 |
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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 | 12/18/2021 |
Sample type | Quality Assurance | A brief description of the sample | concrete cylinders |
The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Zacharia | Last name of sampler or witnessed by | Roush |
Title of sampler | QC Alta Vista | Telephone number of sampler | |
Laboratory sample identification | 1015-1217 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Cemex Fontana | Transportation Laboratory (TL) Number | 1015-1217 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | 1610974 |
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The truck number from where the sample was collected | 10070454 | The batch plant ticket number from where the sample was collected | 30002437 |
Concrete batch plant | Cemex Fontana | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | Grove Ave UC Stem Load 3 | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2021-12-17-6-1 ASTM C39-21 (Verified)