Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2023-06-19-18
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215349 DEA: 081C0824 EFIS: 0816000087 |
|---|---|
| DIST-CO-RTE-PM | 08-RIV-10-R104.9/R134.2 |
| Award Date | 03/24/2021 |
| Closeout Date | Not set |
| Work Description | PLACE HMA (TYPE A), JPCP AND IMPORTED BORROW. |
| Location Description | RIVERSIDE COUNTY FROM ROUTE 10/177 SEPARATION TO 1.1 MILES WEST OF WILEY'S WELL RD OC |
| QA Service Level | 1 (Verified on 03/01/2021) |
Sample Information
| Sample Taken Date | 06/19/2023 | Sample Unique Key | 18 |
|---|---|---|---|
| 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 | 06/20/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 |
| The quantity of what the sample constitutes | 3 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Eduardo | Last name of sampler or witnessed by | Gomez |
| Title of sampler | QA Inspector | Telephone number of sampler | |
| Laboratory sample identification | 1041-163A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Fisher Industries | Transportation Laboratory (TL) Number | 163 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 2102-OPT1 |
|---|---|---|---|
| The truck number from where the sample was collected | 72 | The batch plant ticket number from where the sample was collected | NA |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | RTE 10 177 SEPARATION TO WILEY WELLS RD STA 591200 | 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: 2023-06-19-18-1 ASTM C39-10 (Verified)