Sample Record
Owner Lab
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-01-09-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213746 DEA: 080Q75U4 EFIS: 0817000114 |
|---|---|
| DIST-CO-RTE-PM | 08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2 |
| Award Date | 04/18/2019 |
| Closeout Date | 06/28/2022 |
| Work Description | REPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/17/2019) |
Sample Information
| Sample Taken Date | 01/09/2021 | 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 | 01/20/2021 |
| Sample type | Quality Assurance | A brief description of the sample | CONCRETE CYLINDERS |
| The quantity of what the sample constitutes | CONCRETE CYLINDERS | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | NA | Last name of sampler or witnessed by | NA |
| Title of sampler | RMA | Telephone number of sampler | |
| Laboratory sample identification | 999-109B | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Short Load Concrete Inc | Transportation Laboratory (TL) Number | 999-109B |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | CTS-30-RAM |
|---|---|---|---|
| The truck number from where the sample was collected | NA | The batch plant ticket number from where the sample was collected | NA |
| Concrete batch plant | VOLUMETRIC TRUCK | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | SITE | Where the material sample would have been placed if not sampled | NA |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||