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Sample Record for 2018-09-27-22

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213267 DEA: 04013584 EFIS: 0416000289 QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-80-8.0/8.3,0.9/1.4
Work Description: Pier Retention
Location Description: In San Francisco and Alameda Counties on Yerba Buena Island and .4 miles west of Oakland Toll plaza
Contractor Name: Kiewit/Manson, AJV
Contractor Address: 4650 Business Center Drive, Fairfield,CA 94804
Resident Engineer: Brian Boal Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2018-09-27-22
TL Number from the TL Form:
Sample Submitted By Organization: CT SC - 3676 - 104
Sample Organization Contact:
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 09/27/2018
Date that the sample was received by the laboratory/organization performing the testing: 10/18/2018
The quantity of what the sample constitutes: 135 CY
A brief description of the sample: Concrete Cylinder 6 x 12
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name: San Francisco Observation Structure
The fabricator/manufacturer/facility name: Central Concrete

Material Information

The concrete mix design number: 4E01C5SS
The truck number from where the sample was collected: 1425
The batch plant ticket number from where the sample was collected: 18714786
Concrete batch plant: 30
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Concrete Truck
Where the material sample would have been placed if not sampled: Pier E2 Deck
From Lot No.:
Bag Lot No.:

Test Results