Sample Record
DIME Sample ID 2023-10-23-20
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Project Information
| Project Identifiers | Project ID: 215407 DEA: 043Q9804 EFIS: 0419000291 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-116-39.3/41.8 |
| Award Date | 02/16/2021 |
| Closeout Date | 12/16/2021 |
| Work Description | COLD PLANE AC PAVEMENT AND PLACE RHMA-G. |
| Location Description | SONOMA COUNTY NEAR PETALUMA FROM LAKEVILLE HIGHWAY TO OLD ADOBE ROAD |
| QA Service Level | 1 (Verified on 01/19/2021) |
Owner Lab
- CT D04 - Fairfield Construction Field Office 59-545
Sample Information
| Sample Taken Date | 10/23/2023 | Sample Unique Key | 20 |
|---|---|---|---|
| Date that the sample was received by the laboratory/organization performing the testing | 10/25/2023 | Sample type | Quality Assurance |
| A brief description of the sample | structural concrete | The quantity of what the sample constitutes | three cylinders (6-inch) |
| From where was the sample collected | Job Site | First name of sampler or witnessed by | Kambiz |
| Last name of sampler or witnessed by | Kouchesfani | Title of sampler | Inspector |
| Telephone number of sampler | Laboratory sample identification | ||
| Linked DIME Sample ID | The fabricator/manufacturer/facility name | Cemex | |
| Transportation Laboratory (TL) Number | Inspector Lot Number from the Transportation Laboratory (TL) Form | ||
| Structure unique identifier | 23-0175G | Structure name | E37-E80 Connector |
| Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | 1615674 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 10072281 | |
| Concrete batch plant | 4132 Cordelia Rd | The fabricator/manufacturer designation for the sample | Cemex |
| A detailed description of where the material sample was collected | Taken from concrete truck | Where the material sample would have been placed if not sampled | Pedestals for Bridge Jacking |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||