Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2022-12-07-17
Project Information
Project Identifiers | Project ID: 212112 DEA: 080C2514 EFIS: 0816000076 COOP: 081645 |
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DIST-CO-RTE-PM | 08-SBD-10-0.0/13.2 |
Award Date | 06/06/2018 |
Closeout Date | Not set |
Work Description | Design-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes |
Location Description | LA/SBD County Line to PM 13.2 near I-15 |
QA Service Level | 1 (Verified on 10/16/2019) |
Sample Information
Sample Taken Date | 12/07/2022 | Sample Unique Key | 17 |
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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 | 12/09/2022 |
Sample type | Quality Assurance | A brief description of the sample | Concrete Cylinders |
The quantity of what the sample constitutes | 4 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Edwardo | Last name of sampler or witnessed by | Gomez |
Title of sampler | QA Inspector | Telephone number of sampler | |
Laboratory sample identification | 1015-1207 | Linked DIME Sample ID | 2022-12-07-17 |
The fabricator/manufacturer/facility name | Lane Security Joint Venture | Transportation Laboratory (TL) Number | 1 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | 1613385 |
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The truck number from where the sample was collected | 10064186 | The batch plant ticket number from where the sample was collected | 52261072 |
Concrete batch plant | Cemex Corona | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | Elc Frame 3 - 2 Span 10 and 11 Deck Pour Load 17 | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |