Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-03-17-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-710-6.0-9.4 |
| Award Date | 09/02/2011 |
| Closeout Date | Not set |
| Work Description | Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing. |
| Location Description | Port of Long Beach (District 7) |
| QA Service Level | 1 (Verified on 06/03/2013) |
Sample Information
| Sample Taken Date | 03/17/2015 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 03/23/2015 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | A | Last name of sampler or witnessed by | PICAZO |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 866-99 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Collected at jobsite | Transportation Laboratory (TL) Number | 146299 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | Unknown |
Material Information
| Material Type | Concrete | The concrete mix design number | 804725WHX |
|---|---|---|---|
| The truck number from where the sample was collected | 427 | The batch plant ticket number from where the sample was collected | 5124111 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | C25 P3 CIDH | Where the material sample would have been placed if not sampled | Not set |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||