Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2016-01-27-2
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Project Information
| Project Identifiers | Project ID: 209511 DEA: 080Q7403 EFIS: 0800020456 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-15.4/30.8 |
| Award Date | 10/29/2013 |
| Closeout Date | Not set |
| Work Description | Design Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA. |
| Location Description | On I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH |
| QA Service Level | 1 (Verified on 04/03/2014) |
Sample Information
| Sample Taken Date | 01/27/2016 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 02/01/2016 |
| Sample type | Quality Assurance | A brief description of the sample | 6 x 12 LCB Cylinders |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Joseph | Last name of sampler or witnessed by | Ataei |
| Title of sampler | IQA FIELD INSPECTOR | Telephone number of sampler | Unknown |
| Laboratory sample identification | 878-C25 | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | CEMEX Victorville | Transportation Laboratory (TL) Number | C25 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | Unknown |
Material Information
| Material Type | Concrete | The concrete mix design number | 1202-8 LCB |
|---|---|---|---|
| The truck number from where the sample was collected | Unknown | The batch plant ticket number from where the sample was collected | Not Provided |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Plant |
| A detailed description of where the material sample was collected | Back of the concrete truck | Where the material sample would have been placed if not sampled | SB 15 FWY oak Hill |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2016-01-27-2-1 ASTM C39-17a (Verified)