Sample Record
Owner Lab
- CT HQ - QASI Los Angeles Field Office
DIME Sample ID 2024-04-11-66
Project Information
Project Identifiers | Project ID: 995498 DEA: 072XL104 EFIS: 0724000158 |
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DIST-CO-RTE-PM | 07-LA-10-14.23 |
Award Date | Not set |
Closeout Date | Not set |
Work Description | Column Casings Repair Work |
Location Description | Not set |
QA Service Level | 1 (Verified on 11/20/2023) |
Sample Information
Sample Taken Date | 04/11/2024 | Sample Unique Key | 66 |
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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 | Not set |
Sample type | Department Acceptance | A brief description of the sample | SCC |
The quantity of what the sample constitutes | 9 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Aziz | Last name of sampler or witnessed by | Javahery |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | CATALINA PACIFIC | 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 | 45ESCC |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 1922219 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Discharge chute from back of truck | 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 |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |