Sample Record

Owner Labs

  • CT HQ - Sacramento Docking Station Concrete Laboratory
  • CT D04 - Fairfield Construction Field Office 59-545

DIME Sample ID 2022-08-22-12

Project Information

Project IdentifiersProject ID: 215677
DEA: 044G0804
EFIS: 0412000332
COOP: 042676
DIST-CO-RTE-PM04-SOL-80-R10.4/30.2
Award Date01/18/2022
Closeout DateNot set
Work DescriptionHighway widening, overhead signs, and electronic toll system.
Location DescriptionIn 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 Level1 (Verified on 04/11/2022)

Sample Information

Sample Taken Date08/22/2022 Sample Unique Key12
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 testing08/24/2022
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes3 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed bySimit Last name of sampler or witnessed bySidhu
Title of samplerInspector Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCentral Concrete Fairfield Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameRetaining Wall 5 Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberCT063CR5W
The truck number from where the sample was collected8093 The batch plant ticket number from where the sample was collected181894
Concrete batch plantCentral Concrete The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedTruck Where the material sample would have been placed if not sampledjobsite
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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