Sample Record for 2023-02-22-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994486 DEA: 051Q0804 EFIS: 0522000148
QA Service Level: 1
DIST-CO-RTE-PM: 05-SCR,SCR/SCR-9,1-17.41/17.5
Work Description: Repair of viaduct barrier wall and replace CIDH piles. Holiday Lane Viaduct Slipout. State Route 9 at PM SCR-09-8.4 Jay's Slide, and SR 236 (SCR-236-16.87)
Location Description: Santa Cruz County. State Route 9 at PM SCR-09-8.4 and SR 236 (SCR-236-16.87)
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 580 West Beach St, Watsonville, CA 95076
Resident Engineer: Ian Nguyen Structure Rep.: Stephen Pozzo
Sample Information
DIME Sample ID: 2023-02-22-14
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Monterey Construction Field Laboratory
Sample Organization Contact: 831-818-0254
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 02/22/2023
Date that the sample was received by the laboratory/organization performing the testing: 02/23/2023
The quantity of what the sample constitutes: 40 CY
A brief description of the sample: Concrete Cylinders 4x8
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Las Animas Concrete
Material Information
The concrete mix design number: C1S50
The truck number from where the sample was collected: 114
The batch plant ticket number from where the sample was collected: 366320
Concrete batch plant: Las Animas Concrete
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Chute
Where the material sample would have been placed if not sampled: Pile Cap
From Lot No.:
Bag Lot No.:
Test Results
