Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-03-20-36

Project Information

Project IdentifiersProject ID: 994311
DEA: 080R1704
EFIS: 0812000028
DIST-CO-RTE-PM08-SBD-40-R25.0/R50.0
Award Date12/01/2022
Closeout DateNot set
Work DescriptionCONSTRUCT CSP, CSPA, SSPPA, STR CONC HW, IB, BFM, RSP, & MGS.
Location DescriptionSAN BERNARDINO COUNTY AT NEWBERRY SPRINGS AND LUDLOW FROM 1.6 MILES EAST OF FORT CADY ROAD OVERCROSSING TO CRUCERO ROAD UNDERCROSSING
QA Service Level1 (Verified on 07/28/2023)

Sample Information

Sample Taken Date03/20/2024 Sample Unique Key36
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 testing03/21/2024
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 byFRANCISCO Last name of sampler or witnessed byRUVALCABA
Title of samplerTET Telephone number of sampler
Laboratory sample identification1060-320 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRobertson Transportation Laboratory (TL) Number1060-320
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberSM450P48
The truck number from where the sample was collectedNOT PROVIDED The batch plant ticket number from where the sample was collected2
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedRTE 40 DS39 HEADWALL WB 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
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Sample File Attachments

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Test File Attachments