Sample Record

Owner Lab

  • Con-Fab California, LLC

DIME Sample ID 2023-09-22-69

Project Information

Project IdentifiersProject ID: 993815
DEA: 081C0814
EFIS: 0816000086
DIST-CO-RTE-PM08-RIV-10-R60.7/R74.3
Award Date03/28/2022
Closeout DateNot set
Work DescriptionI-10 PAVEMENT REHABILITATION (SEGMENT 1) PROJECT
Location DescriptionCoachella
QA Service Level1 (Verified on 05/03/2022)

Sample Information

Sample Taken Date09/22/2023 Sample Unique Key69
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 testing09/25/2023
Sample typeQuality Control A brief description of the sampleT-II/V Cement & Flyash Type F
The quantity of what the sample constitutes20 From where was the sample collectedJob Site
First name of sampler or witnessed byJimmy Last name of sampler or witnessed byJuco
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameConfab Shafter Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeConcrete The concrete mix design numberS9.8-25F
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected3769
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedsampled from revolving drum truck into a wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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