Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2016-07-20-6

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout DateNot set
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date07/20/2016 Sample Unique Key6
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 testing07/20/2016
Sample typeQuality Assurance A brief description of the sample6x12
The quantity of what the sample constitutes4 From where was the sample collectedJob Site
First name of sampler or witnessed byHUNG Last name of sampler or witnessed byNGO
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification889-15 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameNATIONAL READY MIX Transportation Laboratory (TL) Number0715
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierRW1630
Structure nameRW1630

Material Information

Material TypeConcrete The concrete mix design numberS62578
The truck number from where the sample was collected455 The batch plant ticket number from where the sample was collected98920
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE Where the material sample would have been placed if not sampledRW 1630 TOP FTG TO TOP OF RW STA 637PLUS40 TO 638PLUS12 AND 636PLUS44 TO 636PLUS68
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.