Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2025-02-27-8
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Project Information
| Project Identifiers | Project ID: 994857 DEA: 010H6104 EFIS: 0117000241 |
|---|---|
| DIST-CO-RTE-PM | 01-HUM-36-13.5/R36.1 |
| Award Date | 10/31/2023 |
| Closeout Date | Not set |
| Work Description | COLD PLANE AND OVERLAY HMA, & REPLACE GUARDRAILS. |
| Location Description | HUMBOLDT COUNTY AT AND NEAR BRIDGEVILLE FROM 3.4 MILES WEST OF GRIZZLY CREEK BRIDGE TO 0.8 MILE EAST OF SOUTH FORK VAN DUZEN RIVER |
| QA Service Level | 1 (Verified on 06/08/2023) |
Sample Information
| Sample Taken Date | 02/27/2025 | Sample Unique Key | 8 |
|---|---|---|---|
| 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 | 02/28/2025 |
| Sample type | Acceptance | A brief description of the sample | Type II Cement |
| The quantity of what the sample constitutes | 30 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Michele | Last name of sampler or witnessed by | Stover |
| Title of sampler | ASR | Telephone number of sampler | 7074966093 |
| Laboratory sample identification | 0377 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Mercer Fraser - Fortuna | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 04-0119 | |
| Structure name | South Fork Van Duzen River Bridge | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | MF CL 1 .40 SLAG AE |
|---|---|---|---|
| The truck number from where the sample was collected | 692 | The batch plant ticket number from where the sample was collected | 109121 |
| Concrete batch plant | Mercer Fraser Fortuna concrete plant | The fabricator/manufacturer designation for the sample | 53768 |
| A detailed description of where the material sample was collected | Ready Mix Chute | Where the material sample would have been placed if not sampled | WB approach barrier 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: 2025-02-27-8-1 CTM 556-January 2018 (Verified)
DIME Test ID: 2025-02-27-8-2 CTM 557-July 2012 (Verified)
DIME Test ID: 2025-02-27-8-3 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-02-27-8-4 CTM 521-June 2020 (Verified)
DIME Test ID: 2025-02-27-8-5 CTM 521-June 2020 (Verified)