Sample Record

Owner Lab

  • CT HQ - QASI Los Angeles Field Office

DIME Sample ID 2024-04-04-5

Project Information

Project IdentifiersProject ID: 212112
DEA: 080C2514
EFIS: 0816000076
COOP: 081645
DIST-CO-RTE-PM08-SBD-10-0.0/13.2
Award Date06/06/2018
Closeout DateNot set
Work DescriptionDesign-Build of I-10 Corridor Contract 1 - Adding 2 new Express Lanes
Location DescriptionLA/SBD County Line to PM 13.2 near I-15
QA Service Level1 (Verified on 10/16/2019)

Sample Information

Sample Taken Date04/04/2024 Sample Unique Key5
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 testing04/04/2024
Sample typeQuality Control A brief description of the sample20 Yards
The quantity of what the sample constitutesTest Sample From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDaves Concrete 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 number123456
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedGirder 1
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBed 1 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
No results found.

Test File Attachments