Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-10-17-23
Project Information
Project Identifiers | Project ID: 215188 DEA: 080F5434 EFIS: 0817000239 Permit Numbers: 0823NMC0369 |
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DIST-CO-RTE-PM | 08-RIV-I-15,SR-91-6.1-7.6 |
Award Date | 03/11/2020 |
Closeout Date | 06/05/2024 |
Work Description | I-15 ELC: 15/91 Express Lanes Connector Project (ELC) |
Location Description | Junction of I-15 and SR-91 in Corona, CA |
QA Service Level | 1 (Verified on 09/16/2020) |
Sample Information
Sample Taken Date | 10/17/2022 | Sample Unique Key | 23 |
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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 | 10/19/2022 |
Sample type | Quality Assurance | A brief description of the sample | 6x12 |
The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Alberto | Last name of sampler or witnessed by | Pineda |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 1026-1017 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | cemex | Transportation Laboratory (TL) Number | 1026-1017 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | 1622748 |
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The truck number from where the sample was collected | 10067255 | The batch plant ticket number from where the sample was collected | 30495727 |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Frame 3 - Stem and Soffit | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2022-10-17-23-1 ASTM C39-10 (Verified)