Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-06-28-37
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215221 DEA: 07332604 EFIS: 0716000287 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-10-R12.4/14.9 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | REMOVE RAISED ISLAND, CONSTRUCT CONCRETE BARRIER AND INSTALL LIGHTING. |
| Location Description | THE COUNTY AND CITY OF LOS ANGELES FROM 0.1 MILE EAST OF ARLINGTON AVENUE OVERCROSSING TO 0.7 MILE EAST OF ROUTE 10/110 SEPARATION |
| QA Service Level | 1 (Verified on 03/19/2021) |
Sample Information
| Sample Taken Date | 06/28/2022 | Sample Unique Key | 37 |
|---|---|---|---|
| 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 | 06/29/2022 |
| Sample type | Acceptance | A brief description of the sample | 6x12 LCB cylinders |
| The quantity of what the sample constitutes | 250 yd3 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Rosauro | Last name of sampler or witnessed by | Nogoy |
| Title of sampler | TEC | Telephone number of sampler | 2137939321 |
| Laboratory sample identification | 22-1595 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertson's | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SC270N31 |
|---|---|---|---|
| The truck number from where the sample was collected | 1371 | The batch plant ticket number from where the sample was collected | 7145924 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Discharge from concrete truck into wheelbarrow. | 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: 2022-06-28-37-1 CTM 521-June 2012 (Verified)