Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-02-06-1

Project Information

Project IdentifiersProject ID: 214671
DEA: 07303904
EFIS: 0714000044
DIST-CO-RTE-PM07-LA-10-31.2/37.2
Award Date11/25/2020
Closeout Date10/11/2023
Work DescriptionLANE REPLACEMENT
Location DescriptionLOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING
QA Service Level1 (Verified on 01/21/2021)

Sample Information

Sample Taken Date02/06/2022 Sample Unique Key1
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 testing02/06/2022
Sample typeQuality Assurance A brief description of the sampleA set of 3 JPCP-RSC concrete beam test specimens
The quantity of what the sample constitutes780 CY From where was the sample collectedJob Site
First name of sampler or witnessed byAli Last name of sampler or witnessed byRehman
Title of samplerField Materials Tester Telephone number of sampler7148753445
Laboratory sample identification22-0221 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving Burbank Batch Plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-21-PRS-237
The truck number from where the sample was collectedLoad 115 The batch plant ticket number from where the sample was collected183932
Concrete batch plantSecurity Paving Burbank Batch Plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from 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
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Sample File Attachments

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Test File Attachments