Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-01-16-9

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout DateNot set
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date01/16/2015 Sample Unique Key9
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 testing01/16/2015
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes4 Bags From where was the sample collectedSource
First name of sampler or witnessed byJeff Last name of sampler or witnessed byPollard
Title of samplerSupervisor of Technical Services Telephone number of samplerUnknown
Laboratory sample identification5112B Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameVulcan Sun Valley Boulevard Transportation Laboratory (TL) NumberC15 31
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)SMARA 91-19-0019
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpiles
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Sizefine
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-01-16-9-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesDanilo FerrerCT - Southern Regional Laboratory01/22/2015Danilo Ferrer
Yes
02/20/2015
2015-01-16-9-2CTM 207-March 2012: Method of Test for Specific Gravity and Absorption of Fine AggregateNader RashidiCT - Southern Regional Laboratory01/23/2015Nader Rashidi
Yes
02/20/2015
2015-01-16-9-3CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandSatish JainCT - Southern Regional Laboratory02/23/2015Satish Jain
Yes
02/20/2015
2015-01-16-9-4CTM 229-June 2011: Method of Test for Durability IndexDanilo FerrerCT - Southern Regional Laboratory01/22/2015Danilo Ferrer
Yes
02/20/2015
2015-01-16-9-5CTM 217-June 2011: Method of Test for Sand EquivalentDanilo FerrerCT - Southern Regional Laboratory01/22/2015Danilo Ferrer
Yes
02/20/2015