Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-07-10-2

Project Information

Project IdentifiersProject ID: 5266
DEA: 08448404
EFIS: 0800000712
COOP: 081488A1
DIST-CO-RTE-PM08-RIV-91-15.6/21.6
Award Date02/10/2012
Closeout DateNot set
Work DescriptionCONSTRUCT HOV LANES AND WIDEN BRIDGES.
Location DescriptionRIVERSIDE COUNTY IN RIVERSIDE FROM ADAMS STREET TO THE ROUTE 60/215 SEPARATION
QA Service Level1 (Verified on 04/27/2012)

Sample Information

Sample Taken Date07/10/2015 Sample Unique Key2
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 testing07/02/2015
Sample typeQuality Assurance A brief description of the sampleConcrete 6 x 12 Cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byModiri Last name of sampler or witnessed byFuad
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification825-14C Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCemex Transportation Laboratory (TL) Number150714C
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameIvy st OH

Material Information

Material TypeConcrete The concrete mix design number1420004
The truck number from where the sample was collectedNot Provided The batch plant ticket number from where the sample was collectedNot Provided
Concrete batch plantNot Provided The fabricator/manufacturer designation for the sampleNot Provided
A detailed description of where the material sample was collectedNot Provided Where the material sample would have been placed if not sampledIvy st OH Replace CIDH piles
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-07-10-2-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory07/30/2015Matthew Clayton
Yes
08/12/2015