Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2024-04-24-27

Project Information

Project IdentifiersProject ID: 214486
DEA: 080K1224
EFIS: 0815000244
DIST-CO-RTE-PM08-SBD-15-R28.6/37.5
Award DateNot set
Closeout DateNot set
Work DescriptionREHBILIATATE EXISTING MAINLINE AND RAMP PAVEMENT
Location DescriptionSAN BERNARDINO COUNTY IN HESPERIA AND VICTORVILLE FROM OAK HILL ROAD OVERCROSSING TO 0.1 MILE SOUTH OF BEAR VALLEY ROAD OVERCROSSING
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date04/24/2024 Sample Unique Key27
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 testing04/25/2024
Sample typeQuality Assurance A brief description of the sample6X12
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byJareerattana Last name of sampler or witnessed bySirisujarittham
Title of samplerQA Transmat Telephone number of sampler
Laboratory sample identification1042-424 Linked DIME Sample ID
The fabricator/manufacturer/facility nameSULLY Transportation Laboratory (TL) Number1
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-22-PCC-273
The truck number from where the sample was collectedna The batch plant ticket number from where the sample was collected7
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSB I15 Mainline Stage 1E Lane 1 Sta 197+50 to 197+70 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