Sample Record
Owner Labs
- ZZEX DIME Development - AVS Testing External
- CT HQ - Sacramento Materials Management Branch Field Office
DIME Sample ID 2016-12-14-1
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7428 DEA: 07215944 EFIS: 0700001834 |
|---|---|
| DIST-CO-RTE-PM | 07-LA-5-4.0/5.9 |
| Award Date | 08/23/2012 |
| Closeout Date | 07/02/2021 |
| Work Description | RECONSTRUCT AND WIDEN FREEWAY AND UNDERCROSSING STRUCTURES. |
| Location Description | LOS ANGELES COUNTY IN NORWALK FROM 0.4 MILE SOUTH OF SAN ANTONIO DRIVE UNDERCROSSING TO 0.7 MILE NORTH OF PIONEER BOULEVARD UNDERCROSSING |
| QA Service Level | 1 (Verified on 11/07/2012) |
Sample Information
| Sample Taken Date | 12/14/2016 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | Verification | A brief description of the sample | concrete from the bridge deck |
| The quantity of what the sample constitutes | 4 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | brett | Last name of sampler or witnessed by | soldano |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichert | 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 | 123456 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 34564564 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | wheelbarrow | 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 |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||