Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-03-18-2

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 Date03/18/2015 Sample Unique Key2
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 testing03/23/2015
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byA Last name of sampler or witnessed byPICAZO
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification866-00 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCollected at jobsite Transportation Laboratory (TL) Number146300
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameOCEAN BLVD to SR 47 IN LB

Material Information

Material TypeConcrete The concrete mix design number804725WHX
The truck number from where the sample was collected412 The batch plant ticket number from where the sample was collected5124120
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedA8N P4 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.