Sample Record
Owner Labs
- CT HQ - Sacramento Materials Management Branch Field Office
- CT D04 - Fairfield Construction Field Office 59-545
DIME Sample ID 2022-07-25-22
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215677 DEA: 044G0804 EFIS: 0412000332 COOP: 042676 |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80-R10.4/30.2 |
| Award Date | 01/18/2022 |
| Closeout Date | Not set |
| Work Description | Highway widening, overhead signs, and electronic toll system. |
| Location Description | In Solano County in Fairfield and Vacaville from 1.0 mile west of Red Top Road Undercrossing to 0.4 mile east of Leisure Town Road Overcrossing. |
| QA Service Level | 1 (Verified on 04/11/2022) |
Sample Information
| Sample Taken Date | 07/25/2022 | Sample Unique Key | 22 |
|---|---|---|---|
| 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 | 07/27/2022 |
| Sample type | Quality Assurance | A brief description of the sample | Structural Concrete |
| The quantity of what the sample constitutes | 358 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Simrit | Last name of sampler or witnessed by | Sidhu |
| Title of sampler | ASR | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Syar Fairfield | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Retaining Wall 5 |
Material Information
| Material Type | Concrete | The concrete mix design number | CT063CR5W |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 88082842 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Back of truck discharge chute | Where the material sample would have been placed if not sampled | |
| 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. | |||