Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-04-15-5

Project Information

Project IdentifiersProject ID: 209019
DEA: 071952U4
EFIS: 0700000201
DIST-CO-RTE-PM07-VEN-23,101-3.3/3.8,R0.1/R4.5
Award Date11/21/2013
Closeout Date06/25/2019
Work DescriptionWIDEN FREEWAY AND RAMPS AND RECONSTRUCT MEDIAN.
Location DescriptionVENTURA COUNTY IN THOUSAND OAKS ON ROUTE 101 FROM 0.6 MILE SOUTH OF WESTLAKE BOULEVARD OVERCROSSING TO 0.4 MILE NORTH OF MOORPARK ROAD UNDERCROSSING AND ON ROUTE 23 FROM ROUTE 101 TO 0.1 MILE NORTH OF HILLCREST DRIVE UNDERCROSSING
QA Service Level1 (Verified on 08/13/2013)

Sample Information

Sample Taken Date04/15/2015 Sample Unique Key5
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 testing04/21/2015
Sample typeQuality Control A brief description of the sample6X12
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byA Last name of sampler or witnessed byMAGHSOUDLOO
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification876-19 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCollected at jobsite Transportation Laboratory (TL) Number106619
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberS72017
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedNOT PROVIDED
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE 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
2015-04-15-5-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory04/24/2015Matthew Clayton
Yes
04/24/2015
2015-04-15-5-2CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory05/13/2015Matthew Clayton
Yes
05/13/2015