Sample Record

Owner Lab

  • Alta Vista Solutions - Whittier

DIME Sample ID 2022-11-18-56

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 Date11/18/2022 Sample Unique Key56
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing11/18/2022
Sample typeQuality Assurance A brief description of the sample3 Concrete Beams Regular
The quantity of what the sample constitutes10 Cubic Yards From where was the sample collectedJob Site
First name of sampler or witnessed byDominic Last name of sampler or witnessed byMontemayor
Title of sampler Telephone number of sampler
Laboratory sample identification22-3073 Linked DIME Sample ID
The fabricator/manufacturer/facility namen/a Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberLB060008
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected7363098
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedWheelbarrow 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
2022-11-18-56-1CTM 504-June 2010: Method of Test for Determining Air Content of Freshly Mixed Concrete by the Pressure MethodDominic Montemayor, Alta Vista Solutions - Whittier11/18/2022Treyvon GriffinBryant
Yes
12/07/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-11-18-56-1 CTM 504-June 2010 (Verified)