Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2022-02-06-12
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 | Not set |
| Closeout Date | Not set |
| 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 | 02/06/2022 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 01/06/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 1 x 4 PCC Aggregate |
| The quantity of what the sample constitutes | 300 CYS | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Gerardo | Last name of sampler or witnessed by | Zubieta |
| Title of sampler | Transportation Engineer | Telephone number of sampler | 2137924795 |
| Laboratory sample identification | 5554 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Flat Iron | Transportation Laboratory (TL) Number | 924023 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0023 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | JPCP | The fabricator/manufacturer designation for the sample | Portable Plant |
| The plant number | A detailed description of where the material sample was collected | Conveyor Belt at Plant | |
| Where the material sample would have been placed if not sampled | PCC SLAB | Primary Aggregate Nominal Size | 1 inch |
| The concrete mix design number | FWI 3018-A1 | Lot number | |
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-02-06-12-1 CTM 202-November 2011 (Verified)