Sample Record

Owner Lab

  • CT D07 - Santa Fe Springs Structures Construction Field Office 1

DIME Sample ID 2016-07-21-2

Project Information

Project IdentifiersProject ID: 209141
DEA: 07215954
EFIS: 0700001835
DIST-CO-RTE-PM07-LA-5-0.0/7.6
Award Date04/24/2014
Closeout Date07/14/2022
Work DescriptionWIDENING FREEWAY AND RECONSTRUCT OVERHEAD AND OVERCROSSING STRUCTURES
Location DescriptionLOS ANGELES COUNTY IN LA MIRADA, SANTA FE SPRINGS, NORWALK AND DOWNEY FROM ORANGE COUNTY/LOS ANGELES COUNTY LIMIT LINES TO 0.7 MILE NORTH OF ROUTE 605
QA Service Level1 (Verified on 06/02/2014)

Sample Information

Sample Taken Date07/21/2016 Sample Unique Key2
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 testing07/22/2016
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byHtoon Last name of sampler or witnessed byWin
Title of samplerASR Telephone number of sampler(626)864-9940
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCT Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameRW 314

Material Information

Material TypeConcrete The concrete mix design numberS72019
The truck number from where the sample was collected429 The batch plant ticket number from where the sample was collected183863
Concrete batch plant2 The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCIDH piles, 108 and 110. Where the material sample would have been placed if not sampledCIDH Piles
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments