Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2024-04-09-23

Project Information

Project IdentifiersProject ID: 994820
DEA: 060V1104
EFIS: 0616000208
DIST-CO-RTE-PM06-FRE,KIN-5,41,198-Var
Award Date08/31/2023
Closeout Date05/09/2025
Work DescriptionSTRATFORD KINGS RIVER BRIDGE REPLACEMENT.
Location DescriptionFRESNO AND KINGS COUNTIES AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 09/20/2023)

Sample Information

Sample Taken Date04/09/2024 Sample Unique Key23
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 testing04/10/2024
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes6 cylinder- 4X8 From where was the sample collectedJob Site
First name of sampler or witnessed byFares Last name of sampler or witnessed byThwabah
Title of samplerASR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMCM Construction 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 numberNCT09064
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected921849
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 sampledPier 7 and 6 CISS Piles
From Lot No. Bag Lot No.

Submitted Tests

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