Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-06-24-49
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215220 DEA: 07210624 EFIS: 0719000068 |
|---|---|
| DIST-CO-RTE-PM | 07-LA,SBD-71-1.8/R4.7&R0.0/R0.2 |
| Award Date | 02/05/2021 |
| Closeout Date | Not set |
| Work Description | PLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP. |
| Location Description | IN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE. |
| QA Service Level | 1 (Verified on 03/24/2021) |
Sample Information
| Sample Taken Date | 06/24/2022 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 | 06/27/2022 |
| Sample type | Acceptance | A brief description of the sample | 6X12 PCC cylinder |
| The quantity of what the sample constitutes | 130 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Oscar | Last name of sampler or witnessed by | Rodriguez |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | |
| Laboratory sample identification | 22-0165 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Robertsons Pomona | Transportation Laboratory (TL) Number | 07-210624-016 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SC675B38 |
|---|---|---|---|
| The truck number from where the sample was collected | 1777 | The batch plant ticket number from where the sample was collected | 7045831 |
| Concrete batch plant | Robertsons Ready Mix Pomona | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | truck chute | 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: 2022-06-24-49-1 CTM 521-June 2020 (Verified)