Sample Record

Owner Labs

  • CT D07 - Plant Services
  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2022-12-29-10

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 Date12/29/2022 Sample Unique Key10
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 testing12/30/2022
Sample typeAcceptance A brief description of the sampleCoarse and fine aggregate
The quantity of what the sample constitutesTwo Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byBaher Last name of sampler or witnessed byFakhoury
Title of sampler Telephone number of sampler2137937180
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameRobertson's Pomona Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-33-0061
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberRRM17066 Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-12-29-10-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesBaher Fakhoury, CT D07 - Plant Services01/04/2023Baher Fakhoury
Yes
01/27/2023
2022-12-29-10-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Baher Fakhoury, CT D07 - Plant Services01/04/2023Baher Fakhoury
Yes
01/27/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2022-12-29-10-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-12-29-10-2 CTM 227-December 2014 (Verified)