Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2013-11-15-7500

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/02/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date11/15/2013 Sample Unique Key7500
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 testing12/13/2013
Sample typeVerification A brief description of the sampleSCC
The quantity of what the sample constitutesTwo 4x8 concrete cylinders From where was the sample collectedSource
First name of sampler or witnessed byRyan Last name of sampler or witnessed byCummings
Title of samplerQA Inspector Telephone number of samplerNot set
Laboratory sample identificationNot set Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameConFab Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeConcrete The concrete mix design numberV95-25F
The truck number from where the sample was collectedNot set The batch plant ticket number from where the sample was collectedunknown
Concrete batch plantNot set The fabricator/manufacturer designation for the sampleNot set
A detailed description of where the material sample was collectedBy formwork at precast plant during pour inspection Where the material sample would have been placed if not sampledNot set
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2013-11-15-7500-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensStanley Mak, CT HQ - QASI Bay Area Field Office12/27/2013Stanley Mak
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2013-11-15-7500-1 ASTM C39-10