Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2025-01-15-15

Project Information

Project IdentifiersProject ID: 993141
DEA: 060V1204
EFIS: 0616000207
DIST-CO-RTE-PM06-MAD-99-R6.9/R7.6
Award Date06/22/2022
Closeout Date12/02/2025
Work DescriptionCottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS.
Location DescriptionMADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING
QA Service Level1 (Verified on 07/28/2021)

Sample Information

Sample Taken Date01/15/2025 Sample Unique Key15
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing01/15/2025
Sample typeAcceptance A brief description of the sampleSkid Testing Request
The quantity of what the sample constitutesMultiple Lanes From where was the sample collectedJob Site
First name of sampler or witnessed byRYan Last name of sampler or witnessed byWilson
Title of samplerRE Telephone number of sampler9166019091
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSecurity Paving company Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier00-0020
Structure nameRoadway Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberBuilders - JPCP Mix
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedUnknown
Concrete batch plantBuilders Concrete Batch Plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedUnknown Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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