Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-06-04-3

Project Information

Project IdentifiersProject ID: 3951
DEA: 07202114
EFIS: 0700020869
DIST-CO-RTE-PM07-LA-710-17.2/26.4
Award Date04/04/2012
Closeout Date06/16/2021
Work DescriptionPAVE ROADWAY WITH LONG LIFE PAVEMENT AND WIDEN ROADWAY AND BRIDGES
Location DescriptionLOS ANGELES COUNTY ON ROUTE 710 AT VARIOUS LOCATIONS FROM LOS ANGELES RIVER BRIDGE TO RAMONA BOULEVARD UNDERCROSSING
QA Service Level1 (Verified on 11/27/2012)

Sample Information

Sample Taken Date06/04/2015 Sample Unique Key3
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 testing06/08/2015
Sample typeQuality Control A brief description of the sample6X12
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byB Last name of sampler or witnessed byNGO
Title of samplerTE Telephone number of samplerUnknown
Laboratory sample identification837-11 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) Number145611
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameBARRIER AT FLORAL UC

Material Information

Material TypeConcrete The concrete mix design numberNP
The truck number from where the sample was collectedNP The batch plant ticket number from where the sample was collectedNP
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedNP Where the material sample would have been placed if not sampledUnknown
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments