Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-03-30-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214573 DEA: 073096U4 EFIS: 0719000091 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-210-R0.0/R9.7 |
| Award Date | 04/03/2020 |
| Closeout Date | 06/06/2024 |
| Work Description | PLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL. |
| Location Description | LOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 06/05/2020) |
Sample Information
| Sample Taken Date | 03/30/2022 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 testing | 03/30/2022 |
| Sample type | Department Acceptance | A brief description of the sample | Concrete |
| The quantity of what the sample constitutes | 10 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Chad | Last name of sampler or witnessed by | Chotibhongs |
| Title of sampler | MREA | Telephone number of sampler | 213-817-0387 |
| Laboratory sample identification | 22-0648 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertsons - North Hollywood | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SC425N49 |
|---|---|---|---|
| The truck number from where the sample was collected | 1698 | The batch plant ticket number from where the sample was collected | 101C6557213 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Discharge from concrete truck into wheelbarrow. | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-03-30-1-1 CTM 518-June 2010 (Verified)