Sample Record
Owner Lab
- CT SC - 3672 - Fairfield
DIME Sample ID 2019-06-26-4
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Project Information
| Project Identifiers | Project ID: 213635 DEA: 044H9804 EFIS: 0413000351 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-4.6/5.7 |
| Award Date | 01/03/2019 |
| Closeout Date | 03/26/2020 |
| Work Description | INSTALL CONCRETE BARRIER AND DRAINAGE IMPROVEMENTS |
| Location Description | MARIN COUNTY NEAR MILL VALLEY FROM REDWOOD HIGHWAY FRONTAGE ROAD TO ROUTE 131 (TIBURON BOULEVARD/EAST BLITHEDALE AVENUE) |
| QA Service Level | 1 (Verified on 02/01/2019) |
Sample Information
| Sample Taken Date | 06/26/2019 | 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 | 06/28/2019 |
| Sample type | Quality Assurance | A brief description of the sample | 6" x 12" |
| The quantity of what the sample constitutes | 36cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Janine | Last name of sampler or witnessed by | Marr |
| Title of sampler | SR | Telephone number of sampler | 5103856764 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | CIDH CB3 | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 4158HSV |
|---|---|---|---|
| The truck number from where the sample was collected | 1434 | The batch plant ticket number from where the sample was collected | 178191 |
| Concrete batch plant | Shamrock Materials | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | CHUTE OF TRUCK | Where the material sample would have been placed if not sampled | type 60M Barrier |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-06-26-4-1 ASTM C39-10
DIME Test ID: 2019-06-26-4-3 ASTM C39-10 (Verified)