Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2022-12-21-20
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Project Information
| Project Identifiers | Project ID: 214451 DEA: 07303704 EFIS: 0714000035 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-101-8.0/27.3 |
| Award Date | 12/19/2019 |
| Closeout Date | Not set |
| Work Description | REPLACE CONCRETE BARRIERS. |
| Location Description | THE CITY AND COUNTY OF LOS ANGELES FROM PILGRIMAGE OVERCROSSING TO VALLEY CIRCLE BOULEVARD OVERCROSSING |
| QA Service Level | 1 (Verified on 08/12/2020) |
Sample Information
| Sample Taken Date | 12/21/2022 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 12/21/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 3/8" X #8 |
| The quantity of what the sample constitutes | 70 CY | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Kevin | Last name of sampler or witnessed by | Hopkins |
| Title of sampler | Plant Inspector | Telephone number of sampler | |
| Laboratory sample identification | KH112L | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | National RM Canoga Park | Transportation Laboratory (TL) Number | C122122B |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0046 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | National RM Canoga Park | A detailed description of where the material sample was collected | Conveyor Belt |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
| The concrete mix design number | S58522 | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-12-21-20-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-12-21-20-2 CTM 227-December 2014 (Verified)