Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-06-04-4

Project Information

Project IdentifiersProject ID: 208862
DEA: 080K7104
EFIS: 0800000366
DIST-CO-RTE-PM08-SBD-15,215-14.0/R16.4,16.0/17.8
Award Date11/13/2012
Closeout Date02/13/2017
Work DescriptionI-15/I-215 Interchange Improvements (Devore)
Location DescriptionOn 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 Level1 (Verified on 06/10/2013)

Sample Information

Sample Taken Date06/04/2015 Sample Unique Key4
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 byEDWARD Last name of sampler or witnessed byMU
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification868-04 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) Number150504
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierBR 24
Structure nameBRIDGE 24 HIGH HINGE

Material Information

Material TypeConcrete The concrete mix design numberCTI-C4500DI
The truck number from where the sample was collected1 The batch plant ticket number from where the sample was collected1672596
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE 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
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
No results found.

Test File Attachments