Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2019-08-05-6
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Project Information
| Project Identifiers | Project ID: 210617 DEA: 042J1004 EFIS: 0414000426 COOP: 042549 |
|---|---|
| DIST-CO-RTE-PM | 04-NAP-29-11.3/11.6 |
| Award Date | 02/27/2019 |
| Closeout Date | 09/28/2021 |
| Work Description | CONSTRUCT TWO SEPARATE ROUNDABOUT PROJECTS TOGETHER INTO ONE SINGLE PROJECT AND CONSTRUCTION CONTRACT. |
| Location Description | AT THE INTERSECTIONS OF FIRST STREET/ CALIFORNIA BLVD AND SECOND STREET/CALIFORNIA BLVD (CITY) AND AT HE STATE ROUTE 29 NORTHBOUND ON AND OFF RAMPS AND FIRST STREET ( CALTRANS) |
| QA Service Level | 1 (Verified on 08/19/2019) |
Sample Information
| Sample Taken Date | 08/05/2019 | Sample Unique Key | 6 |
|---|---|---|---|
| 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 | 08/06/2019 |
| Sample type | Quality Assurance | A brief description of the sample | Cement Type II/V |
| The quantity of what the sample constitutes | 2 - 6x12 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Elaine | Last name of sampler or witnessed by | Yip |
| Title of sampler | Assistant Structures Rep | Telephone number of sampler | 5105017727 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | 212704 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Retaining Wall 1 and 2 | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 4201A |
|---|---|---|---|
| The truck number from where the sample was collected | 7 | The batch plant ticket number from where the sample was collected | 729789 |
| Concrete batch plant | Shamrock Materials | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | CHUTE FROM TRUCK | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||