Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2022-03-19-2

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award DateNot set
Closeout DateNot set
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date03/19/2022 Sample Unique Key2
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 testing03/19/2022
Sample typeAcceptance A brief description of the sampleConcrete Test Samples
The quantity of what the sample constitutes260 cu. yd. From where was the sample collectedJob Site
First name of sampler or witnessed byPhilip Last name of sampler or witnessed byMaquiran
Title of samplerMREA Telephone number of sampler2133581518
Laboratory sample identification22-0549 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFlatiron 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 numberFIW 0420-1
The truck number from where the sample was collected22 The batch plant ticket number from where the sample was collected3
Concrete batch plant The fabricator/manufacturer designation for the sampleFlatiron
A detailed description of where the material sample was collectedVolumetric Truck at Chute 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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Test File Attachments