Sample Record
Owner Lab
- CT D01 - Redwood Valley Field Laboratory
DIME Sample ID 2023-06-29-46
Project Information
| Project Identifiers | Project ID: 994090 DEA: 01434804 EFIS: 0100000672 |
|---|---|
| DIST-CO-RTE-PM | 01-MEN-1-62.0/62.3 |
| Award Date | 10/21/2022 |
| Closeout Date | 10/01/2025 |
| Work Description | Pudding Creek Bridge Widening |
| Location Description | MENDOCINO COUNTY IN FORT BRAGG FROM ELM STREET TO PUDDING CREEK ROAD 421 |
| QA Service Level | 1 (Verified on 07/11/2022) |
Sample Information
| Sample Taken Date | 06/29/2023 | Sample Unique Key | 46 |
|---|---|---|---|
| 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 | 06/29/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 7.2 Sk Structural (Corrosive) |
| The quantity of what the sample constitutes | 9 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Rivas |
| Title of sampler | Structure Representative | Telephone number of sampler | 7076665838 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | geoaggregates | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 10-0158 | |
| Structure name | Pudding Creek Bridge | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 7-Sk-Structual |
|---|---|---|---|
| The truck number from where the sample was collected | 10 | The batch plant ticket number from where the sample was collected | 24440 |
| Concrete batch plant | Geoaggregates | 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
Test File Attachments
DIME Test ID: 2023-06-29-46-1 ASTM C39-17a (Verified)
DIME Test ID: 2023-06-29-46-2 CTM 556-March 2016 (Verified)
DIME Test ID: 2023-06-29-46-3 CTM 557-July 2012 (Verified)
