Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-07-15-2
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Project Information
| Project Identifiers | Project ID: 208862 DEA: 080K7104 EFIS: 0800000366 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15,215-14.0/R16.4,16.0/17.8 |
| Award Date | 11/13/2012 |
| Closeout Date | 02/13/2017 |
| Work Description | I-15/I-215 Interchange Improvements (Devore) |
| Location Description | On I-15 from 0.8 mile south of Glen Helen Parkway UC to 1.4 mile north of Kenwood Ave UC And On I-215 from 1.2 mile south of Devore Road OC to the I-15 junction |
| QA Service Level | 1 (Verified on 06/10/2013) |
Sample Information
| Sample Taken Date | 07/15/2015 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 07/16/2015 |
| Sample type | Quality Control | A brief description of the sample | 6x12 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | DARREN | Last name of sampler or witnessed by | HOPPER |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 868-03 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | JOB | Transportation Laboratory (TL) Number | 180603 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | BRIDGE 5 DEVORE OH RT WIDEN |
| Structure name | CIP DECK |
Material Information
| Material Type | Concrete | The concrete mix design number | CT1-C4400DI |
|---|---|---|---|
| The truck number from where the sample was collected | 620 | The batch plant ticket number from where the sample was collected | 103037346 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | CHUTE | Where the material sample would have been placed if not sampled | Unknown |
| 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: 2015-07-15-2-1 CTM 521-November 2014 (Verified)