Sample Record
Owner Lab
- CT D07 Plant Services
DIME Sample ID 2022-03-02-76
Project Information
Project Identifiers | Project ID: 214620 DEA: 07309304 EFIS: 0714000281 |
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DIST-CO-RTE-PM | 07-LA-210,405,605-Various |
Award Date | 03/18/2020 |
Closeout Date | 07/26/2022 |
Work Description | REINFORCE STRUCTURAL CONCRETE BRIDGE AND PLACE RHMA SHOULDER PAVING. |
Location Description | LOS ANGELES COUNTY AT VARIOUS LOCATIONS |
QA Service Level | 1 (Verified on 04/15/2020) |
Sample Information
Sample Taken Date | 03/02/2022 | Sample Unique Key | 76 |
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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 testing | 03/02/2022 |
Sample type | Acceptance | A brief description of the sample | 3/8 |
The quantity of what the sample constitutes | 40 | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Zaid | Last name of sampler or witnessed by | Abdelkhaliq |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | CEMEX LA | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Aggregate | Source Identification (SMARA or name of Pit) | 91-36-0106 |
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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 collected | Conveyor Belt | |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
The concrete mix design number | Lot number | ||
Sublot number | HMA Design ID |