Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-06-11-19
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Project Information
| Project Identifiers | Project ID: 214601 DEA: 041J5694 EFIS: 0419000313 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/21.8 |
| Award Date | 12/03/2019 |
| Closeout Date | 09/28/2022 |
| Work Description | San Mateo US 101 Express Lanes North |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 06/11/2021 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 06/17/2021 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jack | Last name of sampler or witnessed by | Ali |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Jobsite | Transportation Laboratory (TL) Number | 055113 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | CIDH pile for OH sign structure OS40-1 |
Material Information
| Material Type | Concrete | The concrete mix design number | DDLSP8Q3 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | Unknown | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Cement mixer load 1 | Where the material sample would have been placed if not sampled | |
| 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: 2021-06-11-19-1 ASTM C39-17a (Verified)