Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-01-08-4
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 215690 DEA: 074W9504 EFIS: 0720000200 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-91-R12.1/R20.7 |
| Award Date | 06/02/2021 |
| Closeout Date | 05/26/2022 |
| Work Description | INDIVIDUAL SLAB REPLACEMENT. |
| Location Description | LOS ANGELES COUNTY IN LONG BEACH AND CERRITOS FROM ATLANTIC AVENUE UNDERCROSSING TO THE ORANGE COUNTY LINE |
| QA Service Level | 1 (Verified on 08/16/2021) |
Sample Information
| Sample Taken Date | 01/08/2022 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 01/08/2022 |
| Sample type | Quality Assurance | A brief description of the sample | ISR-RSC Beams |
| The quantity of what the sample constitutes | 10 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Rosauro | Last name of sampler or witnessed by | Nogoy |
| Title of sampler | TEC | Telephone number of sampler | 2137939321 |
| Laboratory sample identification | 22-0033 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | SLC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | CTS-65-EHI |
|---|---|---|---|
| The truck number from where the sample was collected | 10 | The batch plant ticket number from where the sample was collected | 2 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Chute into wheelbarrow | Where the material sample would have been placed if not sampled | Panel 2 |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-01-08-4-1 CTM 524-March 2013 (Verified)