Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-07-02-5
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 209217 DEA: 080F5404 EFIS: 0800000136 COOP: 081468 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-91,15-0.0/13.04, 35.64/45.14 |
| Award Date | 09/09/2013 |
| Closeout Date | 09/20/2023 |
| Work Description | SR-91 Corridor Improvement Project: Develop approx. 8 miles of tolled express lanes and related improvements within SR 91 between the Riverside/Orange County line and I-15, including transition areas. |
| Location Description | 08-RIV-91-0.0/13.04; 12-ORA-91-R14.43/R18.91; 08-RIV-15-35.64/45.14 |
| QA Service Level | 1 (Verified on 08/07/2014) |
Sample Information
| Sample Taken Date | 07/02/2015 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 07/02/2015 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | A | Last name of sampler or witnessed by | Salazar |
| Title of sampler | TE | Telephone number of sampler | Unknown |
| Laboratory sample identification | 888-SRL67 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Holliday Rock Chino | Transportation Laboratory (TL) Number | SRL 67 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | BR 14 Stem and Soffit |
Material Information
| Material Type | Concrete | The concrete mix design number | CM5634 |
|---|---|---|---|
| The truck number from where the sample was collected | 645 | The batch plant ticket number from where the sample was collected | 118028611 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Planty |
| A detailed description of where the material sample was collected | Back of Truck | Where the material sample would have been placed if not sampled | BR 14 Stem and Soffit |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2015-07-02-5-1 CTM 521-November 2014 (Verified)
DIME Test ID: 2015-07-02-5-2 CTM 521-November 2014 (Verified)