Sample Record for 2017-05-11-3
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000
QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last
Sample Information
DIME Sample ID: 2017-05-11-3
TL Number from the TL Form: Unknown
Sample Submitted By Organization: Oldcastle Precast, Incorporated - Pleasanton
Sample Organization Contact: (925) 846-8183
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/11/2017
Date that the sample was received by the laboratory/organization performing the testing: 05/11/2017
The quantity of what the sample constitutes: 100 cy
A brief description of the sample: concrete
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Oldcastle Precast
Material Information
The concrete mix design number: 123456
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 12345677
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: wheelbarrow
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown
Test Results
Test 1 of 1
DIME Test ID: 2017-05-11-3-1
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Verified Date: 05/07/2021
Date Tested: 05/11/2017
Submitted By Organization: Oldcastle Precast, Incorporated - Pleasanton
Organization Address: 1233 Quarry Lane, Suite 145,
Organization City: Pleasanton
Organization State: CA
Organization Zipcode: 94566
Organization Email: juan.maiz@oldcastle.com
Organization Phone: (925) 750-6646
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
