Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-01-12-16

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date01/12/2022 Sample Unique Key16
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 testing01/13/2022
Sample typeQuality Assurance A brief description of the sampleconcrete cylinders
The quantity of what the sample constitutes4 From where was the sample collectedJob Site
First name of sampler or witnessed byLarry Last name of sampler or witnessed byF
Title of samplerTE Telephone number of sampler
Laboratory sample identification1015-0112 Linked DIME Sample ID
The fabricator/manufacturer/facility namesecurity paving Transportation Laboratory (TL) Number1
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1610974
The truck number from where the sample was collected10070496 The batch plant ticket number from where the sample was collectedNP
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedRW 1422 footing pour 3 sta 24 50 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
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments