Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2022-10-05-70

Project Information

Project IdentifiersProject ID: 215220
DEA: 07210624
EFIS: 0719000068
DIST-CO-RTE-PM07-LA,SBD-71-1.8/R4.7&R0.0/R0.2
Award Date02/05/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURE CONCRETE RETAINING WALLS & BOX CULVERT AND PLACE JPCP.
Location DescriptionIN LOS ANGELES AND SAN BERNARDINO COUNTIES IN POMONA AND CHINO HILLS FROM 0.2 MILE SOUTH OF MISSION BOULEVARD OVERCROSSING TO 0.2 MILE OF SAN BERNARDINO COUNTY LINE.
QA Service Level1 (Verified on 03/24/2021)

Sample Information

Sample Taken Date10/05/2022 Sample Unique Key70
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 testing10/06/2022
Sample typeDepartment Acceptance A brief description of the sample6X12 PCC cylinder
The quantity of what the sample constitutes130 CY From where was the sample collectedJob Site
First name of sampler or witnessed byOscar Last name of sampler or witnessed byRodriguez
Title of samplerAssistant Structure Representative Telephone number of sampler
Laboratory sample identification22-0306 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Walnut Transportation Laboratory (TL) Number07-210624-029
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1610974
The truck number from where the sample was collected10064183 The batch plant ticket number from where the sample was collected30476114
Concrete batch plantCemex Walnut The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedtruck chute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-10-05-70-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersArnold Truong, CT D07 - Materials Field Laboratory, Unit 195311/02/2022Robert Achuela
Yes
11/07/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-10-05-70-1 CTM 521-June 2020 (Verified)