DIME » All Projects » Project - DEA: 120C1104 » Sample 2023-08-01-20 » Sample Details

Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2023-08-01-20

Project Information

Project IdentifiersProject ID: 213749
DEA: 120C1104
EFIS: 1200000633
DIST-CO-RTE-PM12-ORA-57-20.3/21.6
Award Date04/19/2019
Closeout DateNot set
Work DescriptionSR-57 Lambert Interchange Project: WIDEN BRIDGES AND CONSTRUCT RW, SW, HMA, JPCP AND ELECTRICAL SYSTEMS.
Location DescriptionORANGE COUNTY IN BREA FROM 0.6 MILE SOUTH TO 0.7 MILE NORTH OF LAMBERT ROAD UNDERCROSSING
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date08/01/2023 Sample Unique Key20
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 testing08/08/2023
Sample typePer Request A brief description of the sampleRepair material for CIP
The quantity of what the sample constitutes1 bag of part A 1 container of part B and 1 bag of Agg From where was the sample collectedJob Site
First name of sampler or witnessed byKeivan Last name of sampler or witnessed byHassan
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSika Corporation Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeCementitious BrandSikatop 122 plus
MillNA Type of Cementitious MaterialBlended Cement

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