Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2022-10-26-17
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993116 DEA: 07320004 EFIS: 0716000029 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-14-R31.4/36.5 |
| Award Date | 09/08/2021 |
| Closeout Date | 11/01/2023 |
| Work Description | INSTALL WIRED MESH DRAPERY SYSTEM AND SLOPE AND ROADSIDE PAVING. |
| Location Description | LOS ANGELES COUNTY IN SANTA CLARITA FROM CANYON PARK BOULEVARD UNDERCROSSING TO SPRING CANYON ROAD UNDERCROSSING |
| QA Service Level | 1 (Verified on 07/12/2021) |
Sample Information
| Sample Taken Date | 10/26/2022 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 10/26/2022 |
| Sample type | Department Acceptance | A brief description of the sample | LCB Aggregate |
| The quantity of what the sample constitutes | 2 Bags of Aggregate | From where was the sample collected | Source |
| First name of sampler or witnessed by | Avo | Last name of sampler or witnessed by | Karajian |
| Title of sampler | TET | Telephone number of sampler | 12137986076 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Robertson's Ready Mix | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0033 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | A detailed description of where the material sample was collected | Stockpile | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-10-26-17-1 CTM 202-November 2011 (Verified)