Sample Record

Owner Lab

  • TRC Companies

DIME Sample ID 2021-12-30-1

Project Information

Project IdentifiersProject ID: 215129
DEA: 050N73U4
EFIS: 0520000166
DIST-CO-RTE-PM05-SB-101-7.3/9.6
Award Date10/23/2020
Closeout DateNot set
Work DescriptionSegment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar, headed rebar, welded hoops, column pins.
Location DescriptionSUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE
QA Service Level1 (Verified on 08/24/2020)

Sample Information

Sample Taken Date12/30/2021 Sample Unique Key1
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 testing12/30/2021
Sample typeQuality Control A brief description of the sample1x4 concrete aggregates
The quantity of what the sample constitutes3 yrds From where was the sample collectedSupplier
First name of sampler or witnessed byDarren Last name of sampler or witnessed byLaChaine
Title of samplerMaterials Tester Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHanson Goleta Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameType 80 Barrier

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-42-0003
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedSample Pad
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number63511N0P Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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