Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-04-20-76
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993648 DEA: 081K6504 EFIS: 0819000084 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15,40-Var |
| Award Date | 06/01/2022 |
| Closeout Date | 12/21/2023 |
| Work Description | PLACE POLYESTER CONCRETE OVERLAY, HMA (TYPE A) & CONC APPROACH SLABS. |
| Location Description | SAN BERNARDINO COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 09/29/2022) |
Sample Information
| Sample Taken Date | 04/20/2023 | Sample Unique Key | 76 |
|---|---|---|---|
| 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 | 04/21/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 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 | Derek | Last name of sampler or witnessed by | Nguyen |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 1050-420 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Peterson Chase | Transportation Laboratory (TL) Number | 081k650420230420 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | PCRSC75STR |
|---|---|---|---|
| The truck number from where the sample was collected | 3048 | The batch plant ticket number from where the sample was collected | 383 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Hector Rd 540719L Base of Columns B3C1 and B3C2 | 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: 2023-04-20-76-1 ASTM C39-10 (Verified)