Sample Record
Owner Lab
- CT HQ - FFS - Skid Testing
DIME Sample ID 2024-07-24-33
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Project Information
| Project Identifiers | Project ID: 994636 DEA: 022J9604 EFIS: 0221000153 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-5-VAR |
| Award Date | 05/25/2023 |
| Closeout Date | Not set |
| Work Description | PLACE POLYESTER CONCRETE OVERLAY, HMA (TYPE A), & REPLACE JOINT SEALS. |
| Location Description | SISKIYOU COUNTY AT VARIOUS LOCATIONS FROM OAK STREET UNDERCROSSING TO KLAMATH RIVER BRIDGE AND SEPARATION BRIDGE NO. 02-0134R |
| QA Service Level | 1 (Verified on 08/07/2023) |
Sample Information
| Sample Taken Date | 07/24/2024 | Sample Unique Key | 33 |
|---|---|---|---|
| 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 | 07/24/2024 |
| Sample type | Quality Assurance | A brief description of the sample | Portable Skid Test |
| The quantity of what the sample constitutes | Skid Testing | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jessie | Last name of sampler or witnessed by | Wilson |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Job site | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | South Weed UC |
Material Information
| Material Type | Roadway/Bridge Surface | Pavement Surface Type | Polyester Concrete |
|---|---|---|---|
| Type of Traffic Control Provided | Stationary Lane Closure | DIST-CO-RTE | |
| Direction of Travel | North | Post Mile | |
| Lanes to be Tested | Lane #1 | Station |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-07-24-33-1 CTM 342-August 2012 (Verified)