Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-05-13-6

Project Information

Project IdentifiersProject ID: 209511
DEA: 080Q7403
EFIS: 0800020456
DIST-CO-RTE-PM08-SBD-15-15.4/30.8
Award Date10/29/2013
Closeout DateNot set
Work DescriptionDesign Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA.
Location DescriptionOn I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH
QA Service Level1 (Verified on 04/03/2014)

Sample Information

Sample Taken Date05/13/2015 Sample Unique Key6
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 testing05/15/2015
Sample typeQuality Control A brief description of the sample6X12
The quantity of what the sample constitutes3 From where was the sample collectedJob Site
First name of sampler or witnessed byE Last name of sampler or witnessed byHAMEL
Title of samplerTET Telephone number of samplerUnknown
Laboratory sample identification878-LCB1 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) NumberLCB1
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierSBD I 15
Structure nameNOT PROVIDED

Material Information

Material TypeConcrete The concrete mix design number1202-8
The truck number from where the sample was collected45 The batch plant ticket number from where the sample was collected176
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedLOAD 176 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 Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

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Test File Attachments