Sample Record

Owner Lab

  • CT SC - 3667 - Chico

DIME Sample ID 2025-05-27-28

Project Information

Project IdentifiersProject ID: 1001249
DEA: 031N5504
EFIS: 0325000797
DIST-CO-RTE-PM03-BUT-70-35/36
Award Date11/20/2024
Closeout DateNot set
Work DescriptionMajor Damage Restoration
Location DescriptionBUT 70 Viaduct
QA Service Level1 (Verified on 05/06/2025)

Sample Information

Sample Taken Date05/27/2025 Sample Unique Key28
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 testing05/28/2025
Sample typeQuality Assurance A brief description of the sampleBent 7 Left CIDH Wet Pile Mix
The quantity of what the sample constitutes9 From where was the sample collectedJob Site
First name of sampler or witnessed byJason Last name of sampler or witnessed byCharmbury
Title of samplerASR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMathews Ready Mix Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier12-0209
Structure nameConcow Sidehill Viaduct Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number072335F25O
The truck number from where the sample was collected841 The batch plant ticket number from where the sample was collected16033221
Concrete batch plantMathews Readymix Oroville 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 sampledBent 7 Left CIDH Pile
From Lot No. Bag Lot No.

Submitted Tests

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