Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-07-09-3

Project Information

Project IdentifiersProject ID: 993162
DEA: 07319104
EFIS: 0716000017
DIST-CO-RTE-PM07-LA-91-R11.8
Award Date02/10/2022
Closeout Date01/11/2024
Work DescriptionADJUST VERTICAL CLEARANCE WITH ROADWAY EXCAVATION AND PLACE JPCP.
Location DescriptionLOS ANGELES COUNTY IN LONG BEACH AT NORTHBOUND ROUTE 710 TO EASTBOUND ROUTE 91 CONNECTOR
QA Service Level1 (Verified on 11/30/2021)

Sample Information

Sample Taken Date07/09/2022 Sample Unique Key3
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 testing07/09/2022
Sample typeQuality Assurance A brief description of the sampleA set of 2 LCB-RSC cylinders
The quantity of what the sample constitutes165 From where was the sample collectedJob Site
First name of sampler or witnessed byMarcus Last name of sampler or witnessed byMolina
Title of samplerField Materials Tester Telephone number of sampler19095343477
Laboratory sample identification22-1716 Linked DIME Sample ID
The fabricator/manufacturer/facility nameNot Provided 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 numberCTS-30-RAM
The truck number from where the sample was collectedLoad 2 The batch plant ticket number from where the sample was collected5692
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from 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
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Sample File Attachments

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Test File Attachments