Sample Record
Owner Lab
- Jensen Precast - Fontana
DIME Sample ID 2021-12-20-28
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Project Information
| Project Identifiers | Project ID: 215109 DEA: 081C8504 EFIS: 0813000047 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-74-0.0/5.8 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | ROADWAY EXCAVATION, HOT MIX ASPHALT, AND STRUCTURAL SHOTCRETE WALLS. |
| Location Description | RIVERSIDE COUNTY NEAR LAKE ELSINORE FROM ORANGE COUNTY LINE TO MONTE VISTA STREET |
| QA Service Level | 1 (Verified on 02/24/2021) |
Sample Information
| Sample Taken Date | 12/20/2021 | Sample Unique Key | 28 |
|---|---|---|---|
| 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 | 12/21/2021 |
| Sample type | Quality Control | A brief description of the sample | 6"x12" concrete samples |
| The quantity of what the sample constitutes | 4 cylinders | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Ray | Last name of sampler or witnessed by | Cuevas |
| Title of sampler | QC Manager | Telephone number of sampler | 19094294133 |
| Laboratory sample identification | Jensen Lab | Linked DIME Sample ID | 122021 |
| The fabricator/manufacturer/facility name | Jensen Precast | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 08-1C8504 33 Riv | |
| Structure name | RTA Ortega Highway |
Material Information
| Material Type | Concrete | The concrete mix design number | 10 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 54423 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Conveyor belt | 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: 2021-12-20-28-1 ASTM C39-21 (Verified)