Sample Record for 2024-03-05-46
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994803 DEA: 043J0704 EFIS: 0415000077
QA Service Level: 1
DIST-CO-RTE-PM: 04-CC-80-10.1/13.5
Work Description: Remove PCC and AC, place PCP and AC Resurfacing.
Location Description: Construction on State Highway in Contra Costa County in Hercules and Crockett from Route 80/4 separation to 0.1 mile west of Crockett Viaduct.
Contractor Name: VANGUARD CONSTRUCTION, INC.
Contractor Address: 651 ENTERPRISE CT, LIVERMORE, CA 94550
Resident Engineer: Ta Seng Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-03-05-46
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 03/05/2024
Date that the sample was received by the laboratory/organization performing the testing: 03/05/2024
The quantity of what the sample constitutes: Two Bags
A brief description of the sample: 1x 4 PCC Aggregates +Sand
From where was the sample collected: Manufacturer
Laboratory sample identification: Rich_24_014
Structure unique identifier:
Structure name: Barrier
The fabricator/manufacturer/facility name: Vanguard Mobile San Pablo Plant
Material Information
The concrete mix design number: 590MAC
The truck number from where the sample was collected: 1076
The batch plant ticket number from where the sample was collected: 1076
Concrete batch plant: Vanguard
The fabricator/manufacturer designation for the sample: stock pile
A detailed description of where the material sample was collected: yard stock pile.
Where the material sample would have been placed if not sampled: yes
From Lot No.: stockpile
Bag Lot No.:
Test Results
