Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2022-03-25-30

Project Information

Project IdentifiersProject ID: 215220
DEA: 07210624
EFIS: 0719000068
DIST-CO-RTE-PM07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Award Date02/05/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location DescriptionIN 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 Level1 (Verified on 03/24/2021)

Sample Information

Sample Taken Date03/25/2022 Sample Unique Key30
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing03/28/2022
Sample typeDepartment Acceptance A brief description of the sample3/8
The quantity of what the sample constitutes40 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byzaid Last name of sampler or witnessed byAbdelkhaliq
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameROBERTSONS POMONA 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)91-33-0008
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 collected20
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 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
2022-03-25-30-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesZaid Abdelkhaliq, CT D07 - Plant Services03/30/2022Zaid Abdelkhaliq
Yes
05/24/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-03-25-30-1 CTM 202-November 2011 (Verified)