Sample Record

Owner Lab

  • CT D08 - Fontana Southern Regional Laboratory

DIME Sample ID 2016-11-04-8

Project Information

Project IdentifiersProject ID: 208945
DEA: 07288604
EFIS: 0700021080
COOP: 074663
DIST-CO-RTE-PM07-LA-710-6.0-9.4
Award Date09/02/2011
Closeout DateNot set
Work DescriptionGerald Desmond Bridge Replacement - A Design Build project. IQA samples will be selected by Port/Caltrans representatives and sent to Translab for testing.
Location DescriptionPort of Long Beach (District 7)
QA Service Level1 (Verified on 06/03/2013)

Sample Information

Sample Taken Date11/04/2016 Sample Unique Key8
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 testing11/14/2016
Sample typeQuality Control A brief description of the sampleLightweight Concrete 3x6
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byCARDIEL Last name of sampler or witnessed byBUGARIN
Title of sampler IQA ENGINEER Telephone number of samplerUnknown
Laboratory sample identification866-11 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCELL-CRETE Transportation Laboratory (TL) Number110416RWLCCL11
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierOCEAN BLVD TO SR 47 IN LB
Structure nameWALL R LCC LIFT 11

Material Information

Material TypeConcrete The concrete mix design numberN A
The truck number from where the sample was collectedNA The batch plant ticket number from where the sample was collectedNA
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedTREMIE PIPE 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
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Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments