Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2025-04-14-23

Project Information

Project IdentifiersProject ID: 214469
DEA: 030H08U4
EFIS: 0319000029
DIST-CO-RTE-PM03-SAC-50-L0.2/R6.1
Award Date06/30/2020
Closeout DateNot set
Work DescriptionSac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location DescriptionFROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
QA Service Level1 (Verified on 10/23/2019)

Sample Information

Sample Taken Date04/14/2025 Sample Unique Key23
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 testing04/16/2025
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes9 Cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byAndrew Last name of sampler or witnessed byLopez
Title of samplerASR Telephone number of sampler5308126239
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Jackson Rd Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier24-0317
Structure name59th St Sidewalk Pour Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number1615453
The truck number from where the sample was collected2 The batch plant ticket number from where the sample was collected41184676
Concrete batch plant4706A The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampledSidewalk
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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