Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2023-09-14-73
Project Information
Project Identifiers | Project ID: 993856 DEA: 042J7304 EFIS: 0415000004 |
---|---|
DIST-CO-RTE-PM | 04-SM-101-6.7/7.6 |
Award Date | 03/20/2023 |
Closeout Date | Not set |
Work Description | SM 101 Cordilleras Crk Br Replacement |
Location Description | Not set |
QA Service Level | 1 (Verified on 06/27/2022) |
Sample Information
Sample Taken Date | 09/14/2023 | Sample Unique Key | 73 |
---|---|---|---|
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 | 09/14/2023 |
Sample type | Quality Control | A brief description of the sample | QC Sampling Data |
The quantity of what the sample constitutes | 40cy | From where was the sample collected | Source |
First name of sampler or witnessed by | Connor | Last name of sampler or witnessed by | Pelan |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | KieCon | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | K4050-4212 |
---|---|---|---|
The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 119539 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Concrete from 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: 2023-09-14-73-1 ASTM C39-21 (Verified)