Sample Record
Owner Lab
- CT D07 - Materials Field Laboratory, Unit 1953
DIME Sample ID 2022-10-19-51
Project Information
Project Identifiers | Project ID: 214670 DEA: 07331004 EFIS: 0716000220 |
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DIST-CO-RTE-PM | 07-VEN-101-9.0/9.2 |
Award Date | 04/13/2022 |
Closeout Date | Not set |
Work Description | CONCRETE SLAB REPLACEMENT & GRIND, PAVEMENT & RESURFACE ACE |
Location Description | VENTURA COUNTY IN THOUSAND OAKS FROM NORTHBOUND OFF-RAMP TO SOUTHBOUND OFF-RAMP AT CONEJO COMMERCIAL VEHICLE ENFORCEMENT FACILITIES |
QA Service Level | 1 (Verified on 07/12/2021) |
Sample Information
Sample Taken Date | 10/19/2022 | Sample Unique Key | 51 |
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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 | 10/20/2022 |
Sample type | Acceptance | A brief description of the sample | LCB |
The quantity of what the sample constitutes | 10CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Chad | Last name of sampler or witnessed by | Chotibhongs |
Title of sampler | MREA | Telephone number of sampler | 213-817-2387 |
Laboratory sample identification | 22-2783 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Powell Construction | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | s30c396L0A |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 589884 | |
Concrete batch plant | National Ready Mix | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | Chute discharge into wheel barrel | 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: 2022-10-19-51-1 CTM 521-June 2020 (Verified)