Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-06-10-10

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date06/10/2015 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 testing06/19/2015
Sample typeQuality Control A brief description of the sample2X2 CUBES
The quantity of what the sample constitutes3 From where was the sample collectedJob Site
First name of sampler or witnessed byP Last name of sampler or witnessed byGAN
Title of samplerLAB TECH Telephone number of samplerUnknown
Laboratory sample identification866-2N Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) NumberA2N
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierA2N TIP GROUTING
Structure nameOCEAN BLVD to SR 47 IN LB

Material Information

Material TypeConcrete The concrete mix design numberNA
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedNA
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedNA 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
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Sample File Attachments

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Test File Attachments