Sample Record

Owner Lab

  • Golden State Bridge, Incorporated

DIME Sample ID 2022-08-10-4

Project Information

Project IdentifiersProject ID: 993730
DEA: 010K7704
EFIS: 0121000008
DIST-CO-RTE-PM01-MEN-101,162-14.6,15.9,0.7
Award Date06/15/2022
Closeout Date07/21/2023
Work DescriptionRepair 3 Bridges
Location DescriptionMENDOCINO COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 04/19/2022)

Sample Information

Sample Taken Date08/10/2022 Sample Unique Key4
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 testingNot set
Sample typeQuality Control A brief description of the sampleBonding Material
The quantity of what the sample constitutes20 Bags From where was the sample collectedJob Site
First name of sampler or witnessed byEvan Last name of sampler or witnessed byHuber
Title of samplerProject Manager Telephone number of sampler9254572228
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCTS Cement Manufacturing Corp. Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeRapid Set ManufacturerCTS Cement Manufacturing Corporation
Mix no.0 Materials Received8-10-22
Lot no.61110121 Batch no.61110121

Submitted Tests

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