Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2015-06-18-7

Project Information

Project IdentifiersProject ID: 210012
DEA: 080M2004
EFIS: 0800000467
DIST-CO-RTE-PM08-RIV-371-67.7/72.9
Award Date01/28/2015
Closeout Date11/29/2016
Work DescriptionCONSTRUCT SHOULDER/RETAINING WALL ON BOTH DIRECTIONS OF ROUTE 371
Location DescriptionRIVERSIDE COUNTY NEAR ANZA AND CAHUILLA FROM EAST OF CARY ROAD TO EAST OF KIRBY ROAD
QA Service Level1 (Verified on 10/15/2015)

Sample Information

Sample Taken Date06/18/2015 Sample Unique Key7
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 testing06/22/2015
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byAMIT Last name of sampler or witnessed byJOSHI
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identification911-01 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCollected at jobsite Transportation Laboratory (TL) Number1
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberD9385P
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedNOT PROVIDED
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedHEADWALL DRAINAGE SYSTEM 3 AND 4 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
No results found.

Sample File Attachments

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Test File Attachments