Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2025-06-05-61
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994376 DEA: 044J4604 EFIS: 0415000351 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-116-11.8/R12.2 |
| Award Date | 04/16/2024 |
| Closeout Date | Not set |
| Work Description | REPLACE CURB RAMPS, SIDEWALK, DRIVEWAY, LIGHTING, & SIGNAL. |
| Location Description | SONOMA COUNTY AT GUERNEVILLE FROM BROOKSIDE LANE TO OLD RIVER ROAD |
| QA Service Level | 1 (Verified on 10/27/2022) |
Sample Information
| Sample Taken Date | 06/05/2025 | Sample Unique Key | 61 |
|---|---|---|---|
| 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 | 06/19/2025 |
| Sample type | Quality Assurance | A brief description of the sample | PCC Type 2 Concrete D20115E1 |
| The quantity of what the sample constitutes | TBD | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Harry | Last name of sampler or witnessed by | Suryantoro |
| Title of sampler | ASR | Telephone number of sampler | 7073334263 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | TBD | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | D2115E1 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 294354 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Chute | 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 |
|---|---|---|---|
| 26001338.005A_2025-06-05-61-1_25-HAY-00745_Concrete_Comp | 07/03/2025 | Info |
Test File Attachments
DIME Test ID: 2025-06-05-61-1 ASTM C39-21 (Verified)