Sample Record
Owner Labs
- Kleinfelder, Incorporated - Los Angeles
- CT SC - 3671 - Brea
DIME Sample ID 2024-04-04-6
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212302 DEA: 080C70U4 EFIS: 0815000189 COOP: 081646 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD-210-PM R 25 |
| Award Date | 11/06/2019 |
| Closeout Date | Not set |
| Work Description | The SR 210 Base Line Interchange project, in the City of Highland, includes widening of the Base Line overcrossing at the SR 210, along with additional ramp widening improvements for the northbound on-ramp, northbound off-ramp and southbound on-ramps. |
| Location Description | SR210 Lane Addition work proposes to improve SR 210 within the cities of Highland, Redlands, San Bernardino and unincorporated sections of San Bernardino County, |
| QA Service Level | 2 (Verified on 01/15/2020) |
Sample Information
| Sample Taken Date | 04/04/2024 | Sample Unique Key | 6 |
|---|---|---|---|
| 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 testing | 04/04/2024 |
| Sample type | Quality Control | A brief description of the sample | Girder |
| The quantity of what the sample constitutes | 1 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Adriana | Last name of sampler or witnessed by | Ortiz |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | SFS | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 123 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 123 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Casting Line A1 Bulb Tee Girder B1 | 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. | |||