Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2022-02-07-40

Project Information

Project IdentifiersProject ID: 214451
DEA: 07303704
EFIS: 0714000035
DIST-CO-RTE-PM07-LA-101-8.0/27.3
Award Date12/19/2019
Closeout DateNot set
Work DescriptionREPLACE CONCRETE BARRIERS.
Location DescriptionTHE CITY AND COUNTY OF LOS ANGELES FROM PILGRIMAGE OVERCROSSING TO VALLEY CIRCLE BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 08/12/2020)

Sample Information

Sample Taken Date02/07/2022 Sample Unique Key40
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 testing02/11/2022
Sample typeAcceptance A brief description of the sampleCoarse and fine aggregate
The quantity of what the sample constitutesThree Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byBaher Last name of sampler or witnessed byFakhoury
Title of samplerTET Telephone number of sampler2137937180
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNational Van Nuys Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)United
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedGround Pile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberS58522 Lot number
Sublot number Aggregate Mix NumberNot set

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