Sample Record
Owner Labs
- CT D04 - Fairfield Construction Field Office 59-545
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2023-10-23-21
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994646 DEA: 043Q5804 EFIS: 0419000226 |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-12,37,80,505,680,780-VAR |
| Award Date | 06/29/2023 |
| Closeout Date | 03/27/2024 |
| Work Description | PLACE POLYESTER CONCRETE OVERLAY AND CONSTRUCT APPROACH SLAB. |
| Location Description | SOLANO COUNTY AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 04/11/2023) |
Sample Information
| Sample Taken Date | 10/23/2023 | Sample Unique Key | 21 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | 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 | 18 CY | 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 | QA 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 |
Material Information
| Material Type | Concrete | The concrete mix design number | 1615674 |
|---|---|---|---|
| The truck number from where the sample was collected | 2 | 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 | Discharge from concrete truck into wheelbarrow. | Where the material sample would have been placed if not sampled | Pedestal for Bridge Jacking |
| 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: 2023-10-23-21-2 ASTM C39-17a (Verified)