Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-05-11-49
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7613 DEA: 071218W4 EFIS: 0700021119 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-29.4/31.6 |
| Award Date | 11/29/2012 |
| Closeout Date | 07/31/2023 |
| Work Description | REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS. |
| Location Description | LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/08/2012) |
Sample Information
| Sample Taken Date | 05/11/2022 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 testing | 05/12/2022 |
| Sample type | Acceptance | A brief description of the sample | 6X12 PCC cylinder |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Lenin | Last name of sampler or witnessed by | Orozco |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 22-0122 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | National Ready Mix Concrete Company | Transportation Laboratory (TL) Number | TL 502 505 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | S72001 |
|---|---|---|---|
| The truck number from where the sample was collected | 2014 | The batch plant ticket number from where the sample was collected | 450798 |
| Concrete batch plant | National Ready Mix Concrete Co | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | truck chute | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-05-11-49-1 CTM 521-June 2020 (Verified)