Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-06-16-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 209511 DEA: 080Q7403 EFIS: 0800020456 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-15.4/30.8 |
| Award Date | 10/29/2013 |
| Closeout Date | Not set |
| Work Description | Design Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA. |
| Location Description | On I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH |
| QA Service Level | 1 (Verified on 04/03/2014) |
Sample Information
| Sample Taken Date | 06/16/2015 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 06/18/2015 |
| Sample type | Quality Control | A brief description of the sample | 6x12 |
| The quantity of what the sample constitutes | 3 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | RUBEN | Last name of sampler or witnessed by | ROCHA |
| Title of sampler | CONSULTANT TECH | Telephone number of sampler | Unknown |
| Laboratory sample identification | 878-16 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | JOB | Transportation Laboratory (TL) Number | 1516 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | SBD I15 |
| Structure name | 15NB SEG 2 LN 3 AND 4 |
Material Information
| Material Type | Concrete | The concrete mix design number | 1202-8 |
|---|---|---|---|
| The truck number from where the sample was collected | 18 | The batch plant ticket number from where the sample was collected | 69 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | LOAD 69 | 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: 2015-06-16-2-1 CTM 521-November 2014 (Verified)