Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2021-12-10-21

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS 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 Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date12/10/2021 Sample Unique Key21
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 testing12/10/2021
Sample typeDepartment Acceptance A brief description of the samplecast concrete beams
The quantity of what the sample constitutes700 yds From where was the sample collectedSource
First name of sampler or witnessed byLR Last name of sampler or witnessed byCollier
Title of samplerTET Telephone number of sampler14242327257
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving batch plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameCenter median rte 5 between Artesia and Valley View

Material Information

Material TypeConcrete The concrete mix design numberG3-19-PCC-001
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedna
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSKIPLOADER TO WHEELBARROW Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-12-10-21-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteLR Collier, CT D07 - Materials Field Laboratory, Unit 195301/07/2022LR Collier
Yes
01/12/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-12-10-21-1 CTM 523-May 2020 (Verified)