Sample Record
Owner Labs
- CT SC - 3672 - Fairfield
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-08-03-15
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215000 DEA: 044J4504 EFIS: 0415000350 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-131-0.8 |
| Award Date | 12/24/2020 |
| Closeout Date | 10/26/2022 |
| Work Description | ADA INFRASTRUCTURE |
| Location Description | MARIN COUNTY IN TIBURON AT GREENWOOD COVE DRIVE/BLACKFIELD DRIVE |
| QA Service Level | 1 (Verified on 09/10/2020) |
Sample Information
| Sample Taken Date | 08/03/2021 | Sample Unique Key | 15 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 08/06/2021 |
| Sample type | Quality Assurance | A brief description of the sample | 4 x 8" Cylinders |
| The quantity of what the sample constitutes | 14 cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Hla | Last name of sampler or witnessed by | Ky |
| Title of sampler | Structure Rep | Telephone number of sampler | 510-385-6764 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock Materials | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | CIDH 42 inch | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | SL4707CG |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 1 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Mix Truck Chute | 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: 2021-08-03-15-1 ASTM C39-17a (Verified)