Sample Record

Owner Lab

  • CT D09 - Bishop Field Laboratory

DIME Sample ID 2023-05-12-27

Project Information

Project IdentifiersProject ID: 214135
DEA: 09213404
EFIS: 0900000030
DIST-CO-RTE-PM09-INY-395-29.9/41.8
Award Date10/22/2021
Closeout DateNot set
Work DescriptionROADWAY EXCAVATION, PLACE HMA (TYPE A), AND ALTERNATIVE PIPE CULVERT.
Location DescriptionINYO 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 Level1 (Verified on 05/03/2019)

Sample Information

Sample Taken Date05/12/2023 Sample Unique Key27
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 testing05/12/2023
Sample typeQuality Assurance A brief description of the sample1x4 concrete aggregates
The quantity of what the sample constitutes1 bag From where was the sample collectedJob Site
First name of sampler or witnessed byDustin Last name of sampler or witnessed byFox
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameBelt Cut Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberMix 718216A
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected711 Materials
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSampled at Belt Cut Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments