Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-04-13-39
Project Information
Project Identifiers | Project ID: 214573 DEA: 073096U4 EFIS: 0719000091 |
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DIST-CO-RTE-PM | 07-LA-210-R0.0/R9.7 |
Award Date | 04/03/2020 |
Closeout Date | 06/06/2024 |
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 | 04/13/2022 | Sample Unique Key | 39 |
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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 | 04/13/2022 |
Sample type | Department Acceptance | A brief description of the sample | LCB |
The quantity of what the sample constitutes | 50 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Michelangelo | Last name of sampler or witnessed by | Sese |
Title of sampler | TET | Telephone number of sampler | 310-345-6204 |
Laboratory sample identification | 22-0810 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Flatiron | 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 | LCB-3215-03 |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 5 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Discharge from concrete truck into 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: 2022-04-13-39-1 CTM 521-June 2020 (Verified)