Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2024-02-15-22
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214486 DEA: 080K1224 EFIS: 0815000244 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-15-R28.6/37.5 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | REHBILIATATE EXISTING MAINLINE AND RAMP PAVEMENT |
| Location Description | SAN BERNARDINO COUNTY IN HESPERIA AND VICTORVILLE FROM OAK HILL ROAD OVERCROSSING TO 0.1 MILE SOUTH OF BEAR VALLEY ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 06/23/2021) |
Sample Information
| Sample Taken Date | 02/15/2024 | Sample Unique Key | 22 |
|---|---|---|---|
| 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 | 02/16/2024 |
| Sample type | Quality Assurance | A brief description of the sample | 6X12 |
| The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Nathan | Last name of sampler or witnessed by | Ogbaselassie |
| Title of sampler | QA Consultant | Telephone number of sampler | |
| Laboratory sample identification | 1042-215 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | SULLY Miller | Transportation Laboratory (TL) Number | 1042-215 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | G3-22-PCC-273 |
|---|---|---|---|
| The truck number from where the sample was collected | 24 | The batch plant ticket number from where the sample was collected | 24 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | NB I15 Lane 1, Main St. STA 331.50 | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||