Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-02-24-17

Project Information

Project IdentifiersProject ID: 215050
DEA: 080R1424
EFIS: 0815000201
DIST-CO-RTE-PM08-SBD-40-R125.0/R154.6
Award Date08/26/2020
Closeout Date11/01/2022
Work DescriptionROADWAY EXCAVATION, IMPORT BORROW AND REGRADE THE MEDIAN SLOPE.
Location DescriptionSAN BERNARDINO COUNTY FROM 4.5 MILES EAST OF HOMER WASH BRIDGE TO ARIZONA STATE LINE
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date02/24/2022 Sample Unique Key17
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 testing03/10/2022
Sample typeQuality Assurance A brief description of the sampleConcrete Cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byLarry Last name of sampler or witnessed byFrancisco
Title of samplerTE Telephone number of sampler
Laboratory sample identification1035-1 Linked DIME Sample ID
The fabricator/manufacturer/facility nameNA Transportation Laboratory (TL) Number1035-1
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1619144
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectednot provided
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedI40 DS12 Head Wall Footing Sta 4501-70 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
2022-02-24-17-1ASTM C39-21: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensMatthew Clayton, CT D08 - Fontana Southern Regional Laboratory03/24/2022Matthew Clayton
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-02-24-17-1 ASTM C39-21