Sample Record

Owner Lab

  • CT D04 - Concord Field Laboratory

DIME Sample ID 2023-06-27-124

Project Information

Project IdentifiersProject ID: 994514
DEA: 043Y0504
EFIS: 0423000192
DIST-CO-RTE-PM04-SOL-12112113-var/var
Award Date01/12/2023
Closeout Date03/11/2024
Work DescriptionPAVEMENT REPAIR
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date06/27/2023 Sample Unique Key124
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 testing06/27/2023
Sample typeQuality Assurance A brief description of the sample3/4-INCH-SP Type A
The quantity of what the sample constitutesN/A From where was the sample collectedSource
First name of sampler or witnessed byNick Last name of sampler or witnessed byHall
Title of sampler Telephone number of sampler7072999133
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Vallejo Batch plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-48-0002
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedSample Pickup From Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number411101510LB0122

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments