Sample Record

Owner Lab

  • CT HQ - Vallejo Field Laboratory

DIME Sample ID 2026-06-10-20

Project Information

Project IdentifiersProject ID: 1000970
DEA: 031J6304
EFIS: 0321000023
DIST-CO-RTE-PM03-SAC-99-6.04/7.06
Award DateNot set
Closeout DateNot set
Work DescriptionWILLOW SLOUGH REPLACEMENT
Location DescriptionSACRAMENTO COUNTY NEAR ELK GROVE FROM 0.2 MILE NORTH OF ARNO ROAD TO 0.4 MILE SOUTH OF DILLARD ROAD
QA Service Level1 (Verified on 02/13/2025)

Sample Information

Sample Taken Date06/10/2026 Sample Unique Key20
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 testing06/11/2026
Sample typeQuality Assurance A brief description of the sampleThree 4"x8" Cylinders
The quantity of what the sample constitutes12 CY From where was the sample collectedFabricator
First name of sampler or witnessed byStephen Last name of sampler or witnessed byHaynes
Title of samplerQuality Assurance Inspector Telephone number of sampler5105931179
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCon-Fab California, LLC - Shafter Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameWillow Slough Bridge Bid ItemNot set

Material Information

Material TypePrecast Concrete The concrete mix design numberS_90T25_SOL
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected7487
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete sample from wheelbarrow of 2nd load of concrete Where the material sample would have been placed if not sampledWG2.1#3 Stems
From Lot No. Bag Lot No.

Submitted Tests

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