Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2021-12-09-8
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7613 DEA: 071218W4 EFIS: 0700021119 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-29.4/31.6 |
| Award Date | 11/29/2012 |
| Closeout Date | 07/31/2023 |
| Work Description | REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS. |
| Location Description | LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/08/2012) |
Sample Information
| Sample Taken Date | 12/09/2021 | Sample Unique Key | 8 |
|---|---|---|---|
| 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 | 12/09/2021 |
| Sample type | Department Acceptance | A brief description of the sample | SB5 mainline A line sta.1552+20-1561+40 |
| The quantity of what the sample constitutes | 520 cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Sopheak | Last name of sampler or witnessed by | Chong |
| Title of sampler | TE | Telephone number of sampler | 12138170174 |
| Laboratory sample identification | 21-2939 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Security Paving company | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 21-2939 | |
| Structure name | SB5 mainline A line |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-16-PCC-002 |
|---|---|---|---|
| The truck number from where the sample was collected | 15 | The batch plant ticket number from where the sample was collected | 224306 |
| Concrete batch plant | Security Paving Burbank Batch Plant | The fabricator/manufacturer designation for the sample | SECURITY PAVING |
| A detailed description of where the material sample was collected | Jobsite | Where the material sample would have been placed if not sampled | jobsite |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| 2021-12-09-8-1 | CTM 523-May 2020: Method of Test for Flexural Strength of Concrete | Sopheak Chong, CT D07 - Materials Field Laboratory, Unit 1953 | 01/06/2022 | Sopheak Chong | No | Info |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-12-09-8-1 CTM 523-May 2020