Sample Record
Owner Lab
- CT D06 - Visalia Field Laboratory
DIME Sample ID 2023-02-14-42
Project Information
Project Identifiers | Project ID: 215425 DEA: 06360244 EFIS: 0613000005 |
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DIST-CO-RTE-PM | 06-TUL-99-30.6/35.2 |
Award Date | 04/23/2021 |
Closeout Date | Not set |
Work Description | Widen Freeway & Bridge Construction (Concrete Bridge) |
Location Description | Not set |
QA Service Level | 1 (Verified on 11/01/2021) |
Sample Information
Sample Taken Date | 02/14/2023 | Sample Unique Key | 42 |
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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 testing | 02/14/2023 |
Sample type | Quality Assurance | A brief description of the sample | 3/4" Class II AB |
The quantity of what the sample constitutes | 10123 gm | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Jason | Last name of sampler or witnessed by | Ruiz |
Title of sampler | Consultant Tester | Telephone number of sampler | 5592890420 |
Laboratory sample identification | SB 99 Sta 182+25 Shldr 0-500 tons | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Crushed recycled on site | Transportation Laboratory (TL) Number | 139 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name | SB 99 Shoulder Near Ave 264 |
Material Information
Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | SMARA No. 91-03-0011 |
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The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
The plant number | A detailed description of where the material sample was collected | Stockpile on site | |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/4 inch | |
The concrete mix design number | Lot number | ||
Sublot number | Aggregate Mix Number |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |