Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2023-12-05-61
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Project Information
| Project Identifiers | Project ID: 995263 DEA: 061G3304 EFIS: 0624000029 |
|---|---|
| DIST-CO-RTE-PM | 06-FRE-180-118/138 |
| Award Date | 08/18/2023 |
| Closeout Date | Not set |
| Work Description | FRE 180 Emergency Slope Repairs. |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 10/20/2023) |
Sample Information
| Sample Taken Date | 12/05/2023 | Sample Unique Key | 61 |
|---|---|---|---|
| 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 | 12/06/2023 |
| Sample type | Department Acceptance | A brief description of the sample | Pile # 1 |
| The quantity of what the sample constitutes | 6 concrete cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Sok | Last name of sampler or witnessed by | Thun |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Outback Materials | 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 | 40F5G07 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 150772 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Pile # 1 | 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: 2023-12-05-61-1 CTM 521-June 2020 (Verified)