Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-03-13-1

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date03/13/2015 Sample Unique Key1
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 testing03/17/2015
Sample typeQuality Control A brief description of the sample6X12 cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byRoman Last name of sampler or witnessed byGranados
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRT710 Transportation Laboratory (TL) Number146297
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameC32 pile cap

Material Information

Material TypeConcrete The concrete mix design numberSFI-PCV
The truck number from where the sample was collected370 The batch plant ticket number from where the sample was collected4654723
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedOcean Blvd to SR 47 in longbeach Where the material sample would have been placed if not sampledNot set
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments