Sample Record

Owner Lab

  • TRC Companies

DIME Sample ID 2022-11-02-21

Project Information

Project IdentifiersProject ID: 215753
DEA: 050N72U4
EFIS: 0520000169
DIST-CO-RTE-PM05-SB-101-4.4/R7.7
Award Date03/01/2021
Closeout DateNot set
Work DescriptionPlease cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B.
Location Description101 freeway in Summerland, CA
QA Service Level1 (Verified on 05/06/2021)

Sample Information

Sample Taken Date11/02/2022 Sample Unique Key21
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 testing11/02/2022
Sample typeQuality Assurance A brief description of the samplePCC Aggregates
The quantity of what the sample constitutes10 yards From where was the sample collectedSupplier
First name of sampler or witnessed byJesse Last name of sampler or witnessed byGomez
Title of sampler Telephone number of sampler8055501704
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMartin Marietta Goleta Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-37-0039
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 collectedConveyor Belt at Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Sizefine
The concrete mix design number Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments