Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2024-02-02-12

Project Information

Project IdentifiersProject ID: 995498
DEA: 072XL104
EFIS: 0724000158
DIST-CO-RTE-PM07-LA-10-14.23
Award DateNot set
Closeout DateNot set
Work DescriptionColumn Casings Repair Work
Location DescriptionNot set
QA Service Level1 (Verified on 11/20/2023)

Sample Information

Sample Taken Date02/02/2024 Sample Unique Key12
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeAcceptance A brief description of the sampleSCC
The quantity of what the sample constitutes15 From where was the sample collectedJob Site
First name of sampler or witnessed byAziz Last name of sampler or witnessed byJavahery
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCATALINA PACIFIC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number45ESCC
The truck number from where the sample was collected3866 The batch plant ticket number from where the sample was collected1902829
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBack of truck chute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments