Sample Record for 2025-11-07-10
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994321 DEA: 040K1604 EFIS: 0416000044
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA,CC-80-R7.6/8.0,0.0/13.5
Work Description: CONSTRUCT RHMA, LIGHTING SYSTEM, AND CONCRETE BARRIER.
Location Description: ALAMEDA AND CONTRA COSTA COUNTIES IN ALBANY AND CROCKETT FROM 0.4 MILE SOUTH OF ALAMEDA COUNTY LINE TO 0.2 MILE SOUTH OF POMONA STREET
Contractor Name: Bay Cities Paving & Grading (Jeff Brandt)
Contractor Address: 1450 CIVIC CT, BLDG B #400, CONCORD, CA 94520
Resident Engineer: Wesley Morrison Structure Rep.: Alyssa Inocencio
Sample Information
DIME Sample ID: 2025-11-07-10
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3672 - Richmond
Sample Organization Contact: (510) 231-7108
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 11/07/2025
Date that the sample was received by the laboratory/organization performing the testing: 11/07/2025
The quantity of what the sample constitutes: 18cy
A brief description of the sample: Concrete Test Samples
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Central Concrete
Material Information
The concrete mix design number: DDLSP8Q3
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: TBD
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: CHUTE FROM TRUCK
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
