Sample Record

Owner Lab

  • CT D11 - District 11 Materials Laboratory

DIME Sample ID 2022-04-24-2

Project Information

Project IdentifiersProject ID: 215370
DEA: 11427504
EFIS: 1116000177
DIST-CO-RTE-PM11-SD,IMP-5,7,111,186,188etc-VAR
Award Date03/11/2021
Closeout Date12/01/2023
Work DescriptionINSTALL FIBER OPTIC CABLE AND POINT VEHICLE DETECTION FIELD ELEMENTS.
Location DescriptionSAN DIEGO AND IMPERIAL COUNTIES AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 02/08/2021)

Sample Information

Sample Taken Date04/24/2022 Sample Unique Key2
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 testing04/25/2022
Sample typeQuality Assurance A brief description of the sample1/2" JMF Renewal
The quantity of what the sample constitutes12 boxes, 2 bags, 4 cans From where was the sample collectedSource
First name of sampler or witnessed byMARCO Last name of sampler or witnessed byESTUDILLO
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Otay Transportation Laboratory (TL) Number
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)91-37-0035
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedPlant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix NumberNot set

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