Sample Record for 2017-08-18-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209187 DEA: 04235624 EFIS: 0400000678 COOP: 042583
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL,SM-101-52.0/52.6,0.0/0.6
Work Description: BRIDGE REPLACEMENT
Location Description: SANTA CLARA AND SAN MATEO COUNTIES IN PALO ALTO AND EAST PALO ALTO FROM OREGON EXPRESSWAY OVERCROSSING TO 0.3 MILE SOUTH OF UNIVERSITY AVENUE OVERCROSSING
Contractor Name: GHILOTTI BROS / RM HARRIS JV
Contractor Address: 525 JACOBY STREET, SAN RAFAEL CA 94901
Resident Engineer: Fernando Abela Structure Rep.: Yannaing Tun
Sample Information
DIME Sample ID: 2017-08-18-14
TL Number from the TL Form: Unknown
Sample Submitted By Organization: Twining, Incorporated - Sacramento
Sample Organization Contact: 916-649-9000
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 08/18/2017
Date that the sample was received by the laboratory/organization performing the testing: 08/18/2017
The quantity of what the sample constitutes: 2 Bags
A brief description of the sample: 1x4 / WCS
From where was the sample collected: Manufacturer
Laboratory sample identification: Unknown
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan
Material Information
Source Identification (SMARA, name of Pit or Job Site): Central Concrete
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: Unknown
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
