Sample Record

Owner Labs

  • CT D07 - Plant Services
  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2023-03-24-53

Project Information

Project IdentifiersProject ID: 214573
DEA: 073096U4
EFIS: 0719000091
DIST-CO-RTE-PM07-LA-210-R0.0/R9.7
Award Date04/03/2020
Closeout Date06/06/2024
Work DescriptionPLACE CONCRETE PAVEMENT, BARRIER, HMA, DRAINAGE, AND ELECTRICAL.
Location DescriptionLOS ANGELES COUNTY IN LOS ANGELES FROM INTERSTATE 5 TO WHEATLAND AVENUE UNDERCROSSING
QA Service Level1 (Verified on 06/05/2020)

Sample Information

Sample Taken Date03/24/2023 Sample Unique Key53
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing03/27/2023
Sample typeDepartment Acceptance A brief description of the sampleCoarse and fine aggregate
The quantity of what the sample constitutesTwo Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byBaher Last name of sampler or witnessed byFakhoury
Title of sampler Telephone number of sampler2137937180
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHolliday Rock Sun Valley Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-19-0001
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collected conveyor belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design number4F36H500 Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-03-24-53-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesBaher Fakhoury, CT D07 - Plant Services04/04/2023Baher Fakhoury
Yes
07/06/2023
2023-03-24-53-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Baher Fakhoury, CT D07 - Plant Services04/04/2023Baher Fakhoury
Yes
07/06/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-03-24-53-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-03-24-53-2 CTM 227-December 2014 (Verified)