Sample Record

Owner Lab

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

DIME Sample ID 2016-08-10-3

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 DateNot set
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 Date08/10/2016 Sample Unique Key3
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 testing08/11/2016
Sample typeQuality Assurance A brief description of the sampleType IV cement
The quantity of what the sample constitutes8 From where was the sample collectedJob Site
First name of sampler or witnessed byArmando Last name of sampler or witnessed byHernandez
Title of samplerASR Telephone number of sampler(949)279-8453
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSecurity Paving batch plant Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameOrr and Day Bridge

Material Information

Material TypeConcrete The concrete mix design numberG3-15-STR-002
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected36845
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedDeck, SB, Stage 1 construction Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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