Sample Record

Owner Lab

  • CT D07 - Plant Services

DIME Sample ID 2022-01-29-39

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award Date04/03/2020
Closeout Date06/06/2024
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date01/29/2022 Sample Unique Key39
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 testing02/02/2022
Sample typeDepartment Acceptance A brief description of the sampleLCBRS-Aggregate
The quantity of what the sample constitutes328 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byHonesto Last name of sampler or witnessed byCastillo
Title of samplerMREAS Telephone number of sampler12134537563
Laboratory sample identification5760 Linked DIME Sample ID
The fabricator/manufacturer/facility nameFlatiron Portable Plant - Paxton off-Ramp Transportation Laboratory (TL) NumberC-006550
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)Onsite Stockpile
The fabricator's/manufacturer's product name for the sampleLCBRS Mix The fabricator/manufacturer designation for the sampleMix FIW 110-1
The plant numberPacoima A detailed description of where the material sample was collectedOnsite Stockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberFIW110-1 Lot number
Sublot number Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-01-29-39-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesA. Toledo, CT D07 - Plant Services02/04/2022Honesto Castillo
Yes
05/31/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-01-29-39-1 CTM 202-November 2011 (Verified)