Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2016-09-23-5

Project Information

Project IdentifiersProject ID: 209217
DEA: 080F5404
EFIS: 0800000136
COOP: 081468
DIST-CO-RTE-PM08-RIV-91,15-0.0/13.04, 35.64/45.14
Award Date09/09/2013
Closeout Date09/20/2023
Work DescriptionSR-91 Corridor Improvement Project: Develop approx. 8 miles of tolled express lanes and related improvements within SR 91 between the Riverside/Orange County line and I-15, including transition areas.
Location Description08-RIV-91-0.0/13.04; 12-ORA-91-R14.43/R18.91; 08-RIV-15-35.64/45.14
QA Service Level1 (Verified on 08/07/2014)

Sample Information

Sample Taken Date09/23/2016 Sample Unique Key5
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 testing09/26/2016
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byA Last name of sampler or witnessed byNGUYEN
Title of samplerTET Telephone number of samplerUnknown
Laboratory sample identification888-SRL317 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameHolliday Rock UPLAND Transportation Laboratory (TL) NumberSRL-317
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier91 CIP
Structure name91 CIP

Material Information

Material TypeConcrete The concrete mix design numberCM5634
The truck number from where the sample was collected99 The batch plant ticket number from where the sample was collected118053221
Concrete batch plantNP The fabricator/manufacturer designation for the samplePLANT
A detailed description of where the material sample was collectedLOAD 28 Where the material sample would have been placed if not sampledWALL 144
From Lot No.NP Bag Lot No.Unknown

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