Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-06-16-2

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 Date06/16/2015 Sample Unique Key2
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 testing06/18/2015
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 byRUBEN Last name of sampler or witnessed byROCHA
Title of samplerCONSULTANT TECH Telephone number of samplerUnknown
Laboratory sample identification878-16 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) Number1516
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierSBD I15
Structure name15NB SEG 2 LN 3 AND 4

Material Information

Material TypeConcrete The concrete mix design number1202-8
The truck number from where the sample was collected18 The batch plant ticket number from where the sample was collected69
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedLOAD 69 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-06-16-2-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory06/19/2015Matthew Clayton
Yes
06/19/2015