Sample Record
Owner Lab
- Kleinfelder, Incorporated - Los Angeles
DIME Sample ID 2022-03-29-23
Project Information
Project Identifiers | Project ID: 214336 DEA: 07302404 EFIS: 0713000488 |
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DIST-CO-RTE-PM | 07-VEN-101-37/40 |
Award Date | 11/17/2020 |
Closeout Date | 09/24/2024 |
Work Description | PADRE JUAN REHAB |
Location Description | VEN 101 |
QA Service Level | 1 (Verified on 02/26/2021) |
Sample Information
Sample Taken Date | 03/29/2022 | Sample Unique Key | 23 |
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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 | Quality Assurance | A brief description of the sample | A set of 3 ISR-RSC Beams |
The quantity of what the sample constitutes | 100 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Aleksey | Last name of sampler or witnessed by | Souglobov |
Title of sampler | Field Materials Tester | Telephone number of sampler | 17075835090 |
Laboratory sample identification | 22-0612 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Short Load Concrete Inc | 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 | CTS-65-EHI |
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The truck number from where the sample was collected | Load 2 | The batch plant ticket number from where the sample was collected | NOT PROVIDED |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Concrete from 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 |
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No results found. |
Test File Attachments
DIME Test ID: 2022-03-29-23-1 CTM 524-March 2013 (Verified)