Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-06-11-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7613 DEA: 071218W4 EFIS: 0700021119 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-29.4/31.6 |
| Award Date | 11/29/2012 |
| Closeout Date | 07/31/2023 |
| Work Description | REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS. |
| Location Description | LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/08/2012) |
Sample Information
| Sample Taken Date | 06/11/2015 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 06/15/2015 |
| Sample type | Quality Control | A brief description of the sample | 6x12 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | DAVID | Last name of sampler or witnessed by | WEEKS |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 951)258-8382 |
| Laboratory sample identification | 889-02 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | JOB | Transportation Laboratory (TL) Number | L79 0CPF 002 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | REALIGN ROUTE 5 |
| Structure name | CASTING BED 14 SQ CLASS 200 PILES |
Material Information
| Material Type | Concrete | The concrete mix design number | UV204 |
|---|---|---|---|
| The truck number from where the sample was collected | LOAD4 | The batch plant ticket number from where the sample was collected | 49452 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | TUCKER TRANSPORTER TRUCK | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2015-06-11-1-1 CTM 521-November 2014 (Verified)