Sample Record

Owner Lab

  • CT D08 - Barstow Field Laboratory 1

DIME Sample ID 2022-08-03-26

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date08/03/2022 Sample Unique Key26
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 testing08/03/2022
Sample typeQuality Assurance A brief description of the sample1 x 4 PCC Aggregate and Sand
The quantity of what the sample constitutes4 Bags Coldfeed Agg., 1 Bag Rap From where was the sample collectedManufacturer
First name of sampler or witnessed byLANE SECURITY PAVING Last name of sampler or witnessed byQC
Title of sampler Telephone number of sampler
Laboratory sample identificationTEST 1 AT 900 OF 30CY OUT Linked DIME Sample ID
The fabricator/manufacturer/facility nameLANEsecurity paving Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-36-0040
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number220831 CORD SJR A detailed description of where the material sample was collectedBelt Cut at Vulcan-Corona Drum
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size1-1/2 inch
The concrete mix design number1610974 Lot number
Sublot number Aggregate Mix NumberNot set

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