Sample Record

Owner Labs

  • CT SC - 3676 - 106
  • CT D04 - Concord Field Laboratory

DIME Sample ID 2022-11-29-13

Project Information

Project IdentifiersProject ID: 993424
DEA: 04281204
EFIS: 0400000769
DIST-CO-RTE-PM04-NAP-29,221-5.5/6.7,0.0/0.2
Award Date03/21/2022
Closeout DateNot set
Work DescriptionHMA, RDWY EXCAVATION, STRUCTURAL CONC AND MODIFYING LIGHTING SYSTEMS.
Location DescriptionNAPA COUNTY NEAR NAPA ON ROUTE 29 FROM 0.7 MILE SOUTH TO 0.5 MILE NORTH OF ROUTE 221 AND ON ROUTE 221 FROM 0.2 MILE NORTH OF ROUTE 29 TO ROUTE 29
QA Service Level1 (Verified on 12/08/2021)

Sample Information

Sample Taken Date11/29/2022 Sample Unique Key13
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 testing11/30/2022
Sample typeQuality Assurance A brief description of the sample6x6x21 beams
The quantity of what the sample constitutes3 Beams From where was the sample collectedJob Site
First name of sampler or witnessed byAlex Last name of sampler or witnessed byLong
Title of samplerUnknown Telephone number of sampler530-356-3637
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameShamrock Napa Transportation Laboratory (TL) Number28 - Napa
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier21-0119
Structure nameNapa 29 Roundabout/Off Ramps

Material Information

Material TypeConcrete The concrete mix design numberCT063AR5W
The truck number from where the sample was collected1414 The batch plant ticket number from where the sample was collected736484
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sampleShamrock
A detailed description of where the material sample was collectedBack of truck discharge chute Where the material sample would have been placed if not sampledInside Form
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-11-29-13-1CTM 523-May 2020: Method of Test for Flexural Strength of ConcreteNICK HALL, CT D04 - Concord Field Laboratory12/27/2022Gurind Joshi
Yes
01/04/2023Rainhart machine reads load in lb/sq inch and converted back to load by multiplying the surface area of contact.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2022-11-29-13-1 CTM 523-May 2020 (Verified)