Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-04-14-41
Project Information
Project Identifiers | Project ID: 215220 DEA: 07210624 EFIS: 0719000068 |
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DIST-CO-RTE-PM | 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2 |
Award Date | 02/05/2021 |
Closeout Date | Not set |
Work Description | PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP. |
Location Description | IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE. |
QA Service Level | 1 (Verified on 03/24/2021) |
Sample Information
Sample Taken Date | 04/14/2022 | Sample Unique Key | 41 |
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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 | 04/15/2022 |
Sample type | Department Acceptance | A brief description of the sample | 6X12 PCC cylinder |
The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Ryan | Last name of sampler or witnessed by | Vantine |
Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
Laboratory sample identification | 22-0097 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Robertsons Pomona | Transportation Laboratory (TL) Number | 07-210624-009 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | RRM17066 |
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The truck number from where the sample was collected | 1624 | The batch plant ticket number from where the sample was collected | NA |
Concrete batch plant | Robertsons Pomona | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | Truck chute | Where the material sample would have been placed if not sampled | NA |
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: 2022-04-14-41-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2022-04-14-41-2 CTM 521-June 2020 (Verified)