Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-04-06-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994140 DEA: 09389905 EFIS: 0921000017 MINOR: 09A0887 |
|---|---|
| DIST-CO-RTE-PM | 09--57-13 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | At the Mojave Highway Maintenance Station, construct new area lighting including but not limited to light pole, foundation and electrical components. |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 09/23/2022) |
Sample Information
| Sample Taken Date | 04/06/2023 | 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 | 04/06/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 4x8 Concrete Cylinders |
| The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Joseph | Last name of sampler or witnessed by | Valle |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 1049-406 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Holliday Rock | Transportation Laboratory (TL) Number | 1049-406 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 3F36L001 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | Not Provided | |
| Concrete batch plant | Holliday Rock | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Light Pole Pull Box 5 | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-04-06-20-1 ASTM C39-10 (Verified)
DIME Test ID: 2023-04-06-20-3 ASTM C39-10 (Verified)