Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2015-10-09-3
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7613 DEA: 071218W4 EFIS: 0700021119 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-29.4/31.6 |
| Award Date | 11/29/2012 |
| Closeout Date | 07/31/2023 |
| Work Description | REALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS. |
| Location Description | LOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING |
| QA Service Level | 1 (Verified on 10/08/2012) |
Sample Information
| Sample Taken Date | 10/09/2015 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 | 10/15/2015 |
| Sample type | Quality Control | A brief description of the sample | 6X12 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | HARIOF | Last name of sampler or witnessed by | FRENCH |
| Title of sampler | ASR | Telephone number of sampler | Unknown |
| Laboratory sample identification | S62578 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | National Ready Mix | Transportation Laboratory (TL) Number | 1509 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | FOOTING RW 1607 |
| Structure name | RW1607 FROM STA 604 65 TO 606 84 |
Material Information
| Material Type | Concrete | The concrete mix design number | S62578 |
|---|---|---|---|
| The truck number from where the sample was collected | 475 | The batch plant ticket number from where the sample was collected | 186745 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | SHUTE | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Not set | Bag Lot No. | Not set |
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. | |||