Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2021-12-10-21
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Project Information
| Project Identifiers | Project ID: 211260 DEA: 072159U4 EFIS: 0715000160 |
|---|---|
| DIST-CO-RTE-PM | 07-LA,ORA-5-0.0/1.5, 44.3/44.4 |
| Award Date | 05/27/2016 |
| Closeout Date | 08/01/2023 |
| Work Description | CONSTRUCT HOV LANES AND MIX FLOW LANES. |
| Location Description | LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK |
| QA Service Level | 1 (Verified on 03/16/2016) |
Sample Information
| Sample Taken Date | 12/10/2021 | Sample Unique Key | 21 |
|---|---|---|---|
| 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 | 12/10/2021 |
| Sample type | Acceptance | A brief description of the sample | cast concrete beams |
| The quantity of what the sample constitutes | 700 yds | From where was the sample collected | Source |
| First name of sampler or witnessed by | LR | Last name of sampler or witnessed by | Collier |
| Title of sampler | TET | Telephone number of sampler | 14242327257 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Security Paving batch plant | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Center median rte 5 between Artesia and Valley View |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-19-PCC-001 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | na | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | SKIPLOADER TO WHEELBARROW | 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 |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-12-10-21-1 CTM 523-May 2020 (Verified)