Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2016-10-19-11
Project Information
Project Identifiers | Project ID: 208945 DEA: 07288604 EFIS: 0700021080 COOP: 074663 |
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DIST-CO-RTE-PM | 07-LA-710-6.0-9.4 |
Award Date | 09/02/2011 |
Closeout Date | Not set |
Work Description | Gerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing. |
Location Description | Port of Long Beach (District 7) |
QA Service Level | 1 (Verified on 06/03/2013) |
Sample Information
Sample Taken Date | 10/19/2016 | Sample Unique Key | 11 |
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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 testing | 10/24/2016 |
Sample type | Quality Control | A brief description of the sample | Lightweight Concrete 3x6 |
The quantity of what the sample constitutes | 6 | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Cardiel | Last name of sampler or witnessed by | Bugarin |
Title of sampler | IQA | Telephone number of sampler | Unknown |
Laboratory sample identification | 866-L4 | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | SFI | Transportation Laboratory (TL) Number | 101916RWNLCCL4 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
Structure name | Unknown |
Material Information
Material Type | Concrete | The concrete mix design number | NA |
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The truck number from where the sample was collected | NA | The batch plant ticket number from where the sample was collected | NA |
Concrete batch plant | NA | The fabricator/manufacturer designation for the sample | NA |
A detailed description of where the material sample was collected | Mixed on Site | Where the material sample would have been placed if not sampled | RW N LCC LIFT 4 |
From Lot No. | Unknown | Bag Lot No. | Unknown |
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. |