Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 99999 DEA: 0322222
QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Michael Maksimovich Structure Rep.: Unknown
DIME Sample ID: 2026-02-02-2
TL Number from the TL Form:
Sample Submitted By Organization: Atlas - Denver
Sample Organization Contact: 303-975-9959
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 02/02/2026
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2026
The quantity of what the sample constitutes: 1
A brief description of the sample: Test CTM 342C DIME card
From where was the sample collected: Other
Laboratory sample identification: FFS-ST-001
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Translab Test data
The concrete mix design number: 12345
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: AC-1
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: From AC brain
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
DIME Test ID: 2026-02-02-2-1
Test Method: CTM 342C-August 2012: Method of Test for Surface Skid Resistance with the California Portable Skid Tester (Skid)
Submitted By Organization: Atlas - Denver
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: ian.broddrick@dot.ca.gov
Organization Phone: (916) 741-2680
Data has not been verified.
