Sample Record

Owner Lab

  • Kie-Con, Incorporated - Antioch

DIME Sample ID 2023-09-27-39

Project Information

Project IdentifiersProject ID: 993856
DEA: 042J7304
EFIS: 0415000004
DIST-CO-RTE-PM04-SM-101-6.7/7.6
Award Date03/20/2023
Closeout DateNot set
Work DescriptionSM 101 Cordilleras Crk Br Replacement
Location DescriptionNot set
QA Service Level1 (Verified on 06/27/2022)

Sample Information

Sample Taken Date09/27/2023 Sample Unique Key39
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 testing09/27/2023
Sample typeQuality Control A brief description of the sampleQC Sampling Data
The quantity of what the sample constitutes40cy From where was the sample collectedSource
First name of sampler or witnessed byConnor Last name of sampler or witnessed byPelan
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKieCon Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberK4050-4212
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected119682
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-09-27-39-1ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement ConcreteConnor Pelan, Kie-Con, Incorporated - Antioch09/27/2023Connor Pelan
Yes
09/29/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-09-27-39-1 ASTM C143-10a (Verified)