Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-08-01-13
Project Information
Project Identifiers | Project ID: 213707 DEA: 081C38U4 EFIS: 0817000196 |
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DIST-CO-RTE-PM | 08-RIV-10-6.7/R25.1 |
Award Date | 11/26/2019 |
Closeout Date | 11/01/2023 |
Work Description | Remove concrete pavement and base, and place HMA and JPCP |
Location Description | ROUTE 10/60 SEPARATION IN BEAUMONT TO ROUTE 10/111 SEPARATION NEAR CABAZON. |
QA Service Level | 1 (Verified on 01/09/2020) |
Sample Information
Sample Taken Date | 08/01/2022 | Sample Unique Key | 13 |
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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 | 08/02/2022 |
Sample type | Quality Assurance | A brief description of the sample | concrete cylinders |
The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Mohammed | Last name of sampler or witnessed by | Haque |
Title of sampler | QA Inspector | Telephone number of sampler | |
Laboratory sample identification | 1012-77RR | Linked DIME Sample ID | 2022-08-01-13 |
The fabricator/manufacturer/facility name | Coffman Specialties, Inc | Transportation Laboratory (TL) Number | 71RR |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | 1906-17 |
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The truck number from where the sample was collected | 22 | The batch plant ticket number from where the sample was collected | 20 |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | WB 10 Seg 1 stage 3-B LCB rapid set sta 177.00 | 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 |
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No results found. |
Test File Attachments
DIME Test ID: 2022-08-01-13-1 ASTM C39-10 (Verified)