Sample Record
Owner Lab
- CT SC - 3667 - Redwood Valley/Fort Bragg
DIME Sample ID 2023-05-04-16
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993279 DEA: 010E0904 EFIS: 0113000123 |
|---|---|
| DIST-CO-RTE-PM | 01-MEN-20-33.3/34.4 |
| Award Date | 05/06/2022 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT NEW BRIDGE, REMOVE TWO BRIDGES, EARTHWORK AND PAVING. (Bridge No. 10-0310) |
| Location Description | MENDOCINO COUNTY NEAR UKIAH FROM 0.3 MILE WEST OF RUSSIAN RIVER BRIDGE AND OVERHEAD TO 0.3 MILE EAST OF COUNTY ROAD 144 |
| QA Service Level | 1 (Verified on 10/04/2021) |
Sample Information
| Sample Taken Date | 05/04/2023 | Sample Unique Key | 16 |
|---|---|---|---|
| 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 | 05/05/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 4x8 concrete cylinders |
| The quantity of what the sample constitutes | 930 cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Riley | Last name of sampler or witnessed by | Melvin |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Nor-Cal | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 10-0310 | |
| Structure name | Russian River BOH |
Material Information
| Material Type | Concrete | The concrete mix design number | 718034A |
|---|---|---|---|
| The truck number from where the sample was collected | Load 12 | The batch plant ticket number from where the sample was collected | 43948 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Back of Truck | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||