Sample Record

Owner Lab

  • Kleinfelder, Incorporated - Los Angeles

DIME Sample ID 2022-09-24-10

Project Information

Project IdentifiersProject ID: 993626
DEA: 070W0804
EFIS: 0721000034
DIST-CO-RTE-PM07-LA-405-28.0/31.6
Award Date05/09/2022
Closeout Date07/03/2023
Work DescriptionINDIVIDUAL SLAB REPLACEMENTS.
Location DescriptionLOS ANGELES COUNTY IN CULVER CITY AND LOS ANGELES FROM VENICE BOULEVARD SEPARATION TO WILSHIRE BOULEVARD UNDERCROSSING
QA Service Level1 (Verified on 05/11/2022)

Sample Information

Sample Taken Date09/24/2022 Sample Unique Key10
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 testing09/24/2022
Sample typeQuality Assurance A brief description of the sampleA set of 3 ISR-RSC Beams
The quantity of what the sample constitutes100 CY From where was the sample collectedJob Site
First name of sampler or witnessed byEdmond Last name of sampler or witnessed byJabbour
Title of samplerField Materials Tester Telephone number of sampler9092398226
Laboratory sample identification22-2451 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-220
The truck number from where the sample was collectedLoad 1 The batch plant ticket number from where the sample was collectedNot Provided
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

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