Sample Record for 2023-05-10-49
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215677 DEA: 044G0804 EFIS: 0412000332 COOP: 042676
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80-R10.4/30.2
Work Description: Highway widening, overhead signs, and electronic toll system.
Location Description: In Solano County in Fairfield and Vacaville from 1.0 mile west of Red Top Road Undercrossing to 0.4 mile east of Leisure Town Road Overcrossing.
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Justen Tatum Structure Rep.: Kelsey Littell
Sample Information
DIME Sample ID: 2023-05-10-49
TL Number from the TL Form:
Sample Submitted By Organization: Construction Testing Services Incorporated
Sample Organization Contact: (916) 419-4747
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/10/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2023
The quantity of what the sample constitutes: 33 CY
A brief description of the sample: 4000 psi concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Cemex
Material Information
The concrete mix design number: 1613820
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 30730875
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: truck chute
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
