Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-04-22-1
Project Information
Project Identifiers | Project ID: 209511 DEA: 080Q7403 EFIS: 0800020456 |
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DIST-CO-RTE-PM | 08-SBD-15-15.4/30.8 |
Award Date | 10/29/2013 |
Closeout Date | Not set |
Work Description | Design Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA. |
Location Description | On I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH |
QA Service Level | 1 (Verified on 04/03/2014) |
Sample Information
Sample Taken Date | 04/22/2015 | Sample Unique Key | 1 |
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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 | 04/24/2015 |
Sample type | Verification | A brief description of the sample | 6X12 |
The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | JOSEPH | Last name of sampler or witnessed by | ATAEI |
Title of sampler | IQA FIELD INSPECTOR | Telephone number of sampler | Unknown |
Laboratory sample identification | 878-15 | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | Collected at jobsite | Transportation Laboratory (TL) Number | LCB 15 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | STA 491 80 TO 451 10 |
Structure name | NB SEG 2 LANE 4 AND 5 SHOULDER |
Material Information
Material Type | Concrete | The concrete mix design number | 1202-8 |
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The truck number from where the sample was collected | 28 | The batch plant ticket number from where the sample was collected | 68 |
Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
A detailed description of where the material sample was collected | TRUCK | Where the material sample would have been placed if not sampled | Not set |
From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |