Sample Record for 2024-06-28-79
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995202 DEA: 033H6104 EFIS: 0318000019
QA Service Level: 1
DIST-CO-RTE-PM: 03-PLA-80-42.7/49.3
Work Description: RDWY EXC, HMA, JPCP, ALT PIPELINER, STEEL SOLDIER PILE, MOD LTG SYSTEM
Location Description: PLACER COUNTY ABOUT 9.4 MILES NORTH OF COLFAX FROM 0.5 MILE WEST OF MONTE VISTA OVERCROSSING TO 0.3 MILE EAST OF DRUM FOREBAY OVERCROSSING
Contractor Name: DESILVA GATES CONSTRUCTION, LLC
Contractor Address: 11555 Dublin Blvd, Dublin, CA 94568
Resident Engineer: Tad Sampson Structure Rep.: Jimmer Ross
Sample Information
DIME Sample ID: 2024-06-28-79
TL Number from the TL Form:
Sample Submitted By Organization: Rinker Materials
Sample Organization Contact: (916) 381-3910
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/28/2024
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2024
The quantity of what the sample constitutes: Date's Production
A brief description of the sample: 4x8 concrete cylinders
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Rinker Materials
Material Information
The concrete mix design number: mix5
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 2-13042
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Besser Hopper
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:
Test Results
