Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2024-12-19-11
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Project Information
| Project Identifiers | Project ID: 1000805 DEA: 061G0904 EFIS: 0623000237 |
|---|---|
| DIST-CO-RTE-PM | 06-FRE-41-R28.2 |
| Award Date | 07/10/2023 |
| Closeout Date | Not set |
| Work Description | Fre 41 Santa Ana Pump Replace. Remove existing pump, install temporary pump, and replace pump and associated appurtenances. |
| Location Description | Fresno County along Route 41 near PM R28.2 at Pump Plant between Shaw Ave and Santa Ana Ave. |
| QA Service Level | 1 (Verified on 11/19/2024) |
Sample Information
| Sample Taken Date | 12/19/2024 | Sample Unique Key | 11 |
|---|---|---|---|
| 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 | 12/20/2024 |
| Sample type | Quality Assurance | A brief description of the sample | Pump Pedestal |
| The quantity of what the sample constitutes | 1CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Adam | Last name of sampler or witnessed by | Mahmoud |
| Title of sampler | ASR | Telephone number of sampler | 559-939-3921 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Outback Materials | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 42-0381W | |
| Structure name | Santa Ana Ave Pump Plant | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 63T1G01C |
|---|---|---|---|
| The truck number from where the sample was collected | 86 | The batch plant ticket number from where the sample was collected | 173836 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete from wheelbarrow | Where the material sample would have been placed if not sampled | |
| 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: 2024-12-19-11-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2024-12-19-11-2 CTM 521-June 2020 (Verified)