Sample Record
Owner Lab
- CT D06 - Visalia Field Laboratory
DIME Sample ID 2022-12-12-22
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Project Information
| Project Identifiers | Project ID: 993301 DEA: 060U2804 EFIS: 0615000293 |
|---|---|
| DIST-CO-RTE-PM | 06-TUL-245-1.4,4.2 |
| Award Date | 01/03/2022 |
| Closeout Date | Not set |
| Work Description | PRECAST PRESTRESSED CONCRETE BOX GIRDER AND SLAB, BRIDGE REMOVAL. |
| Location Description | TULARE COUNTY NEAR WOODLAKE AT YOKOHL CREEK BRIDGE AND AT KAWEAH RIVER BRIDGE |
| QA Service Level | 1 (Verified on 10/11/2021) |
Sample Information
| Sample Taken Date | 12/12/2022 | Sample Unique Key | 22 |
|---|---|---|---|
| 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 | 12/24/2022 |
| Sample type | Quality Assurance | A brief description of the sample | Type II Cement Concrete Agg 4x8 Cylinders |
| The quantity of what the sample constitutes | Bridge Deck Pour | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Fares | Last name of sampler or witnessed by | Thwabah |
| Title of sampler | Structure Representative | Telephone number of sampler | 5592875457 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Viking Ready Mix Visalia Shirk Rd | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Tul 245 Kaweah Bridge Deck |
Material Information
| Material Type | Concrete | The concrete mix design number | ND14505 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 116206747 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | 4x8 Concrete Cylinders fabricated on job site | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-12-12-22-1 CTM 521-June 2020 (Verified)
| File Name | Extension | Date Uploaded | Test ID | Actions |
|---|---|---|---|---|
| 06-0U2804_37000_221223_SA_ Test #19_14D | 04/04/2023 | 2022-12-12-22-1 | Info |
DIME Test ID: 2022-12-12-22-2 CTM 521-June 2020 (Verified)