Sample Record
Owner Labs
- CT SC - 3672 - Petaluma
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2018-08-21-10
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212345 DEA: 044G2204 EFIS: 0412000314 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-12-17.75-18.20 |
| Award Date | 12/06/2017 |
| Closeout Date | 03/12/2021 |
| Work Description | PROJECT: SONOMA 12 FARMERS LANE MEDIAN BARRIER MICROPILES |
| Location Description | IN SONOMA COUNTY ON ROUTE 12, IN SANTA ROSA FROM FARMERS LANE TO BRUSH CREEK RD. |
| QA Service Level | 1 (Verified on 10/18/2017) |
Sample Information
| Sample Taken Date | 08/21/2018 | Sample Unique Key | 10 |
|---|---|---|---|
| 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 testing | 08/24/2018 |
| Sample type | Quality Assurance | A brief description of the sample | 6X12 cylinders |
| The quantity of what the sample constitutes | 2 sets | 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 | Transportation Engineer | Telephone number of sampler | 1-707-333-4263 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock Materials | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Route 12 Farmers Lane | |
| Structure name | Type 60 Barrier | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 4158CR |
|---|---|---|---|
| The truck number from where the sample was collected | 1418 | The batch plant ticket number from where the sample was collected | 467577 |
| Concrete batch plant | Shamrock Petaluma | The fabricator/manufacturer designation for the sample | Shamrock Materials |
| A detailed description of where the material sample was collected | Mix Truck Chute | Where the material sample would have been placed if not sampled | Type 60 Median Barrier |
| 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: 2018-08-21-10-1 ASTM C39-10 (Verified)