Sample Record
Owner Lab
- Kleinfelder, Incorporated - Los Angeles
DIME Sample ID 2022-04-02-6
Project Information
Project Identifiers | Project ID: 214671 DEA: 07303904 EFIS: 0714000044 |
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DIST-CO-RTE-PM | 07-LA-10-31.2/37.2 |
Award Date | 11/25/2020 |
Closeout Date | 10/11/2023 |
Work Description | LANE REPLACEMENT |
Location Description | LOS ANGELES COUNTY IN BALDWIN PARK AND WEST COVINA FROM 0.1 MILE EAST OF THE 10/605 SEPARATION TO 0.3 MILE WEST OF CITRUS STREET OVERCROSSING |
QA Service Level | 1 (Verified on 01/21/2021) |
Sample Information
Sample Taken Date | 04/02/2022 | Sample Unique Key | 6 |
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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 | 04/02/2022 |
Sample type | Quality Assurance | A brief description of the sample | A set of 2 LCB RS cylinders |
The quantity of what the sample constitutes | 600 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Ali | Last name of sampler or witnessed by | Rehman |
Title of sampler | Field Materials Tester | Telephone number of sampler | 7148753445 |
Laboratory sample identification | 22-0631 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Security Paving Burbank Batch Plant | 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 | G3-22-LRS-271 |
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The truck number from where the sample was collected | Load 51 | 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: 2022-04-02-6-1 CTM 521-June 2020 (Verified)