Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2016-11-03-1

Project Information

Project IdentifiersProject ID: 7613
DEA: 071218W4
EFIS: 0700021119
DIST-CO-RTE-PM07-LA-5-29.4/31.6
Award Date11/29/2012
Closeout Date07/31/2023
Work DescriptionREALIGN ROUTE 5 AND RAILROAD TRACKS AND RECONFIGURE ON- AND OFF-RAMPS.
Location DescriptionLOS ANGELES COUNTY IN BURBANK FROM WEST MAGNOLIA BOULEVARD OVERCROSSING TO 0.3 MILE NORTH OF BUENA VISTA STREET/WINONA AVENUE UNDERCROSSING
QA Service Level1 (Verified on 10/08/2012)

Sample Information

Sample Taken Date11/03/2016 Sample Unique Key1
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 testing11/03/2016
Sample typeQuality Assurance A brief description of the samplesam
The quantity of what the sample constitutesUnknown From where was the sample collectedJob Site
First name of sampler or witnessed byUnknown Last name of sampler or witnessed bySAM
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJobsite Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberUnknown
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedUnknown
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedUnknown Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments