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

Project Information

Project IdentifiersProject ID: 7428
DEA: 07215944
EFIS: 0700001834
DIST-CO-RTE-PM07-LA-5-4.0/5.9
Award Date08/23/2012
Closeout Date07/02/2021
Work DescriptionRECONSTRUCT AND WIDEN FREEWAY AND UNDERCROSSING STRUCTURES.
Location DescriptionLOS 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 Level1 (Verified on 11/07/2012)

Sample Information

Sample Taken Date12/14/2016 Sample Unique Key1
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 testingNot set
Sample typeVerification A brief description of the sampleconcrete from the bridge deck
The quantity of what the sample constitutes4 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed bybrett Last name of sampler or witnessed bysoldano
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number123456
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected34564564
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

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