Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2021-06-03-32

Project Information

Project IdentifiersProject ID: 215063
DEA: 032F5704
EFIS: 0300020615
DIST-CO-RTE-PM03-PLA-80-46.3/63.5
Award Date09/23/2020
Closeout Date08/11/2023
Work DescriptionReplace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location DescriptionNot set
QA Service Level1 (Verified on 11/16/2020)

Sample Information

Sample Taken Date06/03/2021 Sample Unique Key32
Date that the sample was received by the laboratory/organization performing the testing06/04/2021 Sample typeQuality Assurance
A brief description of the sample6x12 concrete cylinders The quantity of what the sample constitutes2 - 6x12 cylinders
From where was the sample collectedFabricator First name of sampler or witnessed bySaman
Last name of sampler or witnessed byBarzegari Title of sampler
Telephone number of sampler Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameKie-Con Antioch
Transportation Laboratory (TL) Number Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design number000000000000
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected000000000000
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedKie-Con Antioch Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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Test File Attachments