Sample Record
Owner Lab
- CT HQ - QASI Sacramento Field Office
DIME Sample ID 2023-04-06-7
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993580 DEA: 020H5704 EFIS: 0215000052 |
|---|---|
| DIST-CO-RTE-PM | 02-MOD-139-R3.5/30.3 |
| Award Date | 11/10/2022 |
| Closeout Date | 05/06/2024 |
| Work Description | MODOC 139 DRAINAGE - DRAINAGE REHABILITATION |
| Location Description | IN MODOC COUNTY AT VARIOUS LOCATIONS FROM 1.2 MILES NORTH OF HOWARDS GULCH BRIDGE TO 0.1 MILE SOUTH OF CLEAR LAKE ROAD. |
| QA Service Level | 1 (Verified on 03/02/2022) |
Sample Information
| Sample Taken Date | 04/06/2023 | Sample Unique Key | 7 |
|---|---|---|---|
| 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 testing | 04/07/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 4 - 4x8 Cylinders |
| The quantity of what the sample constitutes | 1.70 CY | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Steve | Last name of sampler or witnessed by | Haynes |
| Title of sampler | QA Inspector | Telephone number of sampler | 510-593-1179 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Precast Unlimited | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | PC65A0E1 |
|---|---|---|---|
| The truck number from where the sample was collected | 0034 | The batch plant ticket number from where the sample was collected | 361825 |
| Concrete batch plant | Folsom Ready Mix Anderson CA | The fabricator/manufacturer designation for the sample | JF Shea 4/6 Cast |
| A detailed description of where the material sample was collected | Sample from a wheelbarrow | Where the material sample would have been placed if not sampled | 7 x 3 Box Culvert |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||