Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-04-23-4
Project Information
Project Identifiers | Project ID: 208862 DEA: 080K7104 EFIS: 0800000366 |
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DIST-CO-RTE-PM | 08-SBD-15,215-14.0/R16.4,16.0/17.8 |
Award Date | 11/13/2012 |
Closeout Date | 02/13/2017 |
Work Description | I-15/I-215 Interchange Improvements (Devore) |
Location Description | On I-15 from 0.8 mile south of Glen Helen Parkway UC to 1.4 mile north of Kenwood Ave UC And On I-215 from 1.2 mile south of Devore Road OC to the I-15 junction |
QA Service Level | 1 (Verified on 06/10/2013) |
Sample Information
Sample Taken Date | 04/23/2015 | Sample Unique Key | 4 |
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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 | DARREN | Last name of sampler or witnessed by | HOPPER |
Title of sampler | ASR | Telephone number of sampler | Unknown |
Laboratory sample identification | 868-96 | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | job site | Transportation Laboratory (TL) Number | 180596 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | RW 7 |
Structure name | STEM WALL STA 10 70 TO 11 10 |
Material Information
Material Type | Concrete | The concrete mix design number | CM5800 |
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The truck number from where the sample was collected | 220 | The batch plant ticket number from where the sample was collected | 103033335 |
Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
A detailed description of where the material sample was collected | CHUTE | 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
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2015-04-23-4-1 CTM 521-November 2014 (Verified)