Sample Record
Owner Lab
- CT D04 - Concord Field Laboratory
DIME Sample ID 2023-07-23-9
Project Information
| Project Identifiers | Project ID: 994803 DEA: 043J0704 EFIS: 0415000077 |
|---|---|
| DIST-CO-RTE-PM | 04-CC-80-10.1/13.5 |
| Award Date | 03/10/2023 |
| Closeout Date | 10/06/2025 |
| Work Description | Remove PCC and AC, place PCP and AC Resurfacing. |
| Location Description | Construction on State Highway in Contra Costa County in Hercules and Crockett from Route 80/4 separation to 0.1 mile west of Crockett Viaduct. |
| QA Service Level | 1 (Verified on 05/10/2023) |
Sample Information
| Sample Taken Date | 07/23/2023 | Sample Unique Key | 9 |
|---|---|---|---|
| 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 | 08/01/2023 |
| Sample type | Quality Assurance | A brief description of the sample | HE4x12BM |
| The quantity of what the sample constitutes | Beam 39B | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Nick | Last name of sampler or witnessed by | Hall |
| Title of sampler | Telephone number of sampler | 7072999133 | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Vangaurd | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | East Bound HWY 80 | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | HE4x12BM |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | None | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Dischard fron concrete truck into wheelbarrow. | 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: 2023-07-23-9-3 CTM 524-March 2013 (Verified)
