Sample Record
Owner Lab
- CT D09 - Bishop Field Laboratory
DIME Sample ID 2023-05-04-5
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214135 DEA: 09213404 EFIS: 0900000030 |
|---|---|
| DIST-CO-RTE-PM | 09-INY-395-29.9/41.8 |
| Award Date | 10/22/2021 |
| Closeout Date | Not set |
| Work Description | ROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT. |
| Location Description | INYO COUNTY NEAR OLANCHA AND CARTAGO FROM 1.4 MILES SOUTH OF LOS ANGELES AQUEDUCT BRIDGE TO 0.2 MILE SOUTH OF ASH CREEK BRIDGE |
| QA Service Level | 1 (Verified on 05/03/2019) |
Sample Information
| Sample Taken Date | 05/04/2023 | Sample Unique Key | 5 |
|---|---|---|---|
| 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 | 05/04/2023 |
| Sample type | Quality Assurance | A brief description of the sample | Mix OV-12P |
| The quantity of what the sample constitutes | 5 concrete Cylinders | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Jerid | Last name of sampler or witnessed by | Kupelian |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | 711 materials | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | OV-12P |
|---|---|---|---|
| The truck number from where the sample was collected | Load 3 Truck 26 | The batch plant ticket number from where the sample was collected | 830481 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Emergency work on Drainage Sytems on existing HWY 395 | 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 |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||