Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-08-21-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993626 DEA: 070W0804 EFIS: 0721000034 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-405-28.0/31.6 |
| Award Date | 05/09/2022 |
| Closeout Date | 07/03/2023 |
| Work Description | INDIVIDUAL SLAB REPLACEMENTS. |
| Location Description | LOS ANGELES COUNTY IN CULVER CITY AND LOS ANGELES FROM VENICE BOULEVARD SEPARATION TO WILSHIRE BOULEVARD UNDERCROSSING |
| QA Service Level | 1 (Verified on 05/11/2022) |
Sample Information
| Sample Taken Date | 08/21/2022 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 08/21/2022 |
| Sample type | Acceptance | A brief description of the sample | A set of 3 ISR-RSC Beams |
| The quantity of what the sample constitutes | 140 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Chad | Last name of sampler or witnessed by | Chotibhongs |
| Title of sampler | MREA | Telephone number of sampler | 213-817-0387 |
| Laboratory sample identification | 22-2144 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | NA | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-220 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | NA | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Discharge from back of concrete truck CHUTE into wheelbarrow. | 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 |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-08-21-2-1 CTM 524-March 2013 (Verified)