Sample Record

DIME Sample ID 2019-08-05-6

Project Information

Project IdentifiersProject ID: 210617
DEA: 042J1004
EFIS: 0414000426
COOP: 042549
DIST-CO-RTE-PM04-NAP-29-11.3/11.6
Award Date02/27/2019
Closeout Date09/28/2021
Work DescriptionCONSTRUCT TWO SEPARATE ROUNDABOUT PROJECTS TOGETHER INTO ONE SINGLE PROJECT AND CONSTRUCTION CONTRACT.
Location DescriptionAT 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 Level1 (Verified on 08/19/2019)

Owner Lab

  • CT HQ - QASI Bay Area Field Office

Sample Information

Sample Taken Date08/05/2019 Sample Unique Key6
Date that the sample was received by the laboratory/organization performing the testing08/06/2019 Sample typeQuality Assurance
A brief description of the sampleCement Type II/V The quantity of what the sample constitutes2 - 6x12 cylinders
From where was the sample collectedJob Site First name of sampler or witnessed byElaine
Last name of sampler or witnessed byYip Title of samplerAssistant Structures Rep
Telephone number of sampler5105017727 Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameShamrock
Transportation Laboratory (TL) Number212704 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure nameRetaining Wall 1 and 2
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number4201A
The truck number from where the sample was collected7 The batch plant ticket number from where the sample was collected729789
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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