Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2022-01-26-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214620 DEA: 07309304 EFIS: 0714000281 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-210,405,605-Various |
| Award Date | 03/18/2020 |
| Closeout Date | 07/26/2022 |
| Work Description | REINFORCE STRUCTURAL CONCRETE BRIDGE AND PLACE RHMA SHOULDER PAVING. |
| Location Description | LOS ANGELES COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 04/15/2020) |
Sample Information
| Sample Taken Date | 01/26/2022 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 testing | 02/02/2022 |
| Sample type | Department Acceptance | A brief description of the sample | 1x4 pcc aggregate |
| The quantity of what the sample constitutes | 50 CY | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Victor | Last name of sampler or witnessed by | Pham |
| Title of sampler | TET | Telephone number of sampler | 2137924794 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Cemex | Transportation Laboratory (TL) Number | C-0126A1 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | 5749 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-36-0106::WHITE MOUNTAIN QUARRY |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | PCC mix | The fabricator/manufacturer designation for the sample | mix 1612109 |
| The plant number | Los Angeles | A detailed description of where the material sample was collected | Plant Stockpile |
| Where the material sample would have been placed if not sampled | barrier | Primary Aggregate Nominal Size | 1 inch |
| The concrete mix design number | 1612109 | Lot number | |
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||