Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2024-11-06-14
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Project Information
| Project Identifiers | Project ID: 993141 DEA: 060V1204 EFIS: 0616000207 |
|---|---|
| DIST-CO-RTE-PM | 06-MAD-99-R6.9/R7.6 |
| Award Date | 06/22/2022 |
| Closeout Date | Not set |
| Work Description | Cottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS. |
| Location Description | MADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING |
| QA Service Level | 1 (Verified on 07/28/2021) |
Sample Information
| Sample Taken Date | 11/06/2024 | Sample Unique Key | 14 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 11/07/2024 |
| Sample type | Quality Assurance | A brief description of the sample | Stage 2 Approach Slab |
| The quantity of what the sample constitutes | 105 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Juan | Last name of sampler or witnessed by | De La Torre |
| Title of sampler | ASR | Telephone number of sampler | 5593630082 |
| Laboratory sample identification | 215 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Builders | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 41-0089 | |
| Structure name | Mainline 99 |
Material Information
| Material Type | Concrete | The concrete mix design number | ND22023 |
|---|---|---|---|
| The truck number from where the sample was collected | 9165 | The batch plant ticket number from where the sample was collected | 1307199 |
| Concrete batch plant | Ashlan | The fabricator/manufacturer designation for the sample | Builders |
| A detailed description of where the material sample was collected | TAIL GATE | Where the material sample would have been placed if not sampled | Mainline 99 abutment 1 approach slab |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-11-06-14-1 CTM 521-June 2020 (Verified)