Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2025-11-21-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1001142 DEA: 01461704 EFIS: 0116000032 |
|---|---|
| DIST-CO-RTE-PM | 01-HUM-36-25.4 |
| Award Date | 05/28/2025 |
| Closeout Date | Not set |
| Work Description | WATER TREATMENT SYSTEM UPGRADE AND REPLACE ASPHALT CONCRETE SURFACING. |
| Location Description | HUMBOLDT COUNTY NEAR BRIDGEVILLE AT THE BRIDGEVILLE MAINTENANCE STATION |
| QA Service Level | 1 (Verified on 05/05/2025) |
Sample Information
| Sample Taken Date | 11/21/2025 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 | 11/21/2025 |
| Sample type | Quality Assurance | A brief description of the sample | Type II-V Cement & GGBF |
| The quantity of what the sample constitutes | 9 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 | Telephone number of sampler | ||
| Laboratory sample identification | 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 | ||
| Structure name | Bid Item | 24 - BUILDING WORK |
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 | 694 | The batch plant ticket number from where the sample was collected | 51883-1 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Sampled from chute of ready mix truck | 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 |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2025-11-21-4-1 CTM 556-June 2010 (Verified)
DIME Test ID: 2025-11-21-4-2 CTM 557-June 2020 (Verified)