Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2022-05-03-48

Project Information

Project IdentifiersProject ID: 211260
DEA: 072159U4
EFIS: 0715000160
DIST-CO-RTE-PM07-LA,ORA-5-0.0/1.5, 44.3/44.4
Award Date05/27/2016
Closeout Date08/01/2023
Work DescriptionCONSTRUCT HOV LANES AND MIX FLOW LANES.
Location DescriptionLOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
QA Service Level1 (Verified on 03/16/2016)

Sample Information

Sample Taken Date05/03/2022 Sample Unique Key48
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 testing05/04/2022
Sample typeDepartment Acceptance A brief description of the sampleConcrete Beams
The quantity of what the sample constitutes330 yd3 From where was the sample collectedJob Site
First name of sampler or witnessed byRosauro Last name of sampler or witnessed byNogoy
Title of samplerTEC Telephone number of sampler2137939321
Laboratory sample identification22-1020 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-19-PCC-001
The truck number from where the sample was collected15 The batch plant ticket number from where the sample was collected250858
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedFrom loader to wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-05-03-48-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteRosauro Nogoy, CT D07 - Materials Field Laboratory, Unit 195305/31/2022Rosauro Nogoy
Yes
06/01/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-05-03-48-1 CTM 523-May 2020 (Verified)