Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-04-18-19

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date04/18/2022 Sample Unique Key19
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 testing04/19/2022
Sample typeQuality Assurance A brief description of the sampleA set of 2 JPCP concrete beam test specimens
The quantity of what the sample constitutes1,500 CY From where was the sample collectedJob Site
First name of sampler or witnessed byAli Last name of sampler or witnessed byRehman
Title of samplerField Materials Tester Telephone number of sampler7148753445
Laboratory sample identification22-0831 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSECURITY PAVING PORTABLE PLANT- LA MIRADA 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 numberG3-19-PCC-001
The truck number from where the sample was collectedLoad 14 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