Sample Record
Owner Labs
- CT HQ - QASI Los Angeles Field Office
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2021-06-03-1
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Project Information
| Project Identifiers | Project ID: 215075 DEA: 060Q9104 EFIS: 0614000005 |
|---|---|
| DIST-CO-RTE-PM | 06-TUL-99-19.2/19.8 |
| Award Date | 09/25/2020 |
| Closeout Date | 05/11/2023 |
| Work Description | BRIDGE DECK AND OUTSIDE GIRDER REPLACEMENT. |
| Location Description | TULARE COUNTY NEAR TIPTON FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF AVENUE 152 OVERCROSSING |
| QA Service Level | 1 (Verified on 07/28/2020) |
Sample Information
| Sample Taken Date | 06/03/2021 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | 06/04/2021 |
| Sample type | Quality Assurance | A brief description of the sample | (2) 6"x12" Cylinders |
| The quantity of what the sample constitutes | (2) 6"x12" Cylinders | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Rigoberto | Last name of sampler or witnessed by | Marin |
| Title of sampler | AMR | Telephone number of sampler | 9515000685 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Con-Fab California, LLC | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | L133-065-21 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | SCC S9 8 0F |
|---|---|---|---|
| The truck number from where the sample was collected | 2 | The batch plant ticket number from where the sample was collected | 1283 |
| Concrete batch plant | SPC onsite batch plant | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | At pour location | Where the material sample would have been placed if not sampled | Girder |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-06-03-1-1 ASTM C39-18 (Verified)