Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2022-02-06-12

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award Date04/03/2020
Closeout Date06/06/2024
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 Date02/06/2022 Sample Unique Key12
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 testing01/06/2022
Sample typeQuality Assurance A brief description of the sample1 x 4 PCC Aggregate
The quantity of what the sample constitutes300 CYS From where was the sample collectedFabricator
First name of sampler or witnessed byGerardo Last name of sampler or witnessed byZubieta
Title of samplerTransportation Engineer Telephone number of sampler2137924795
Laboratory sample identification5554 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFlat Iron Transportation Laboratory (TL) Number924023
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-19-0023
The fabricator's/manufacturer's product name for the sampleJPCP The fabricator/manufacturer designation for the samplePortable Plant
The plant number A detailed description of where the material sample was collectedConveyor Belt at Plant
Where the material sample would have been placed if not sampledPCC SLAB Primary Aggregate Nominal Size1 inch
The concrete mix design numberFWI 3018-A1 Lot number
Sublot number Aggregate Mix NumberNot set

Combined Gradation Report Information

Combined Gradation Report IdBin IndexDime Test Id
No assigned tests for this sample.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-02-06-12-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesGerardo Zubieta, CT D07 - Plant Services01/06/2022Gerardo Zubieta
Yes
04/11/2022

Sample File Attachments

File NameExtensionDate UploadedActions
No results found.

Test File Attachments


DIME Test ID: 2022-02-06-12-1 CTM 202-November 2011 (Verified)