Sample Record

Owner Lab

  • Alta Vista Solutions - Whittier

DIME Sample ID 2024-08-07-110

Project Information

Project IdentifiersProject ID: 993387
DEA: 07323404
EFIS: 0716000064
DIST-CO-RTE-PM07-LA-5-R59.5/R67.9
Award DateNot set
Closeout DateNot set
Work DescriptionPLACE CULVERT, REPLACE DRAINAGE SYSTEM, RECONST ROADWAY & EMBANKMENT.
Location DescriptionLOS ANGELES COUNTY AT VARIOUS LOCATIONS FROM LAKE HUGHES ROAD UNDERCROSSING TO 1.9 MILES NORTH OF TEMPLIN HIGHWAY UNDERCROSSING
QA Service Level1 (Verified on 12/06/2021)

Sample Information

Sample Taken Date08/07/2024 Sample Unique Key110
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 testing08/07/2024
Sample typeQuality Assurance A brief description of the sampleA set of 3 JPCP RSC beams
The quantity of what the sample constitutes10 cubic yards From where was the sample collectedJob Site
First name of sampler or witnessed byAlberto Last name of sampler or witnessed byPineda-Gonzalez
Title of sampler Telephone number of sampler
Laboratory sample identification24-2417 Linked DIME Sample ID
The fabricator/manufacturer/facility nameN/A 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 numberG# 21 CTS 221
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected1
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

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Test File Attachments