Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2016-06-10-13

Project Information

Project IdentifiersProject ID: 209732
DEA: 072881U4
EFIS: 0714000085
DIST-CO-RTE-PM07-LA-210-R16.1/R25.8
Award Date02/06/2015
Closeout Date02/18/2020
Work DescriptionCONSTRUCT CONCRETE PAVEMENT, PRECAST CONCRETE PANELS, AND SLABS.
Location DescriptionLOS ANGELES COUNTY IN LA CANADA FLINTRIDGE, GLENDALE AND PASADENA FROM DUNSMORE AVENUE UNDERCROSSING TO NORTH LOS ROBLES AVENUE OVERCROSSING
QA Service Level1 (Verified on 11/04/2014)

Sample Information

Sample Taken Date06/10/2016 Sample Unique Key13
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 testing06/14/2016
Sample typeQuality Assurance A brief description of the sample1 gallon can
The quantity of what the sample constitutes2 tankers From where was the sample collectedManufacturer
First name of sampler or witnessed byP Last name of sampler or witnessed byR
Title of sampleroperation manager Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility namereichhold azusa Transportation Laboratory (TL) Numberc240499
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypePolyester Mfg. Lot Number(s)0000983919
Batch number0000983919 Mix number

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