Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-03-29-22

Project Information

Project IdentifiersProject ID: 214336
DEA: 07302404
EFIS: 0713000488
DIST-CO-RTE-PM07-VEN-101-37/40
Award Date11/17/2020
Closeout Date09/24/2024
Work DescriptionPADRE JUAN REHAB
Location DescriptionVEN 101
QA Service Level1 (Verified on 02/26/2021)

Sample Information

Sample Taken Date03/29/2022 Sample Unique Key22
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 testing03/30/2022
Sample typeQuality Assurance A brief description of the sampleA set of 3 ISR-RSC Beams
The quantity of what the sample constitutes100 CY From where was the sample collectedJob Site
First name of sampler or witnessed byAleksey Last name of sampler or witnessed bySouglobov
Title of samplerField Materials Tester Telephone number of sampler17075835090
Laboratory sample identification22-0611 Linked DIME Sample ID
The fabricator/manufacturer/facility nameShort Load Concrete Inc 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 numberCTS-65-EHI
The truck number from where the sample was collectedLoad 2 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 collectedConcrete from wheelbarrow 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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Sample File Attachments

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Test File Attachments