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Sample Record for 2013-06-07-11289624

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

Project Information

Project ID: 999 DEA: 032E1404 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-50-24.0/29.6
Work Description: Widen Roadway and Surface near Hazel Ave
Location Description:
Contractor Name: Martin Brothers Construction
Contractor Address: 20 Light Sky Court, Sacramento, CA 95828
Resident Engineer: Ryan Novota Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2013-06-07-11289624
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 06/07/2013
Date that the sample was received by the laboratory/organization performing the testing: 06/30/2013
The quantity of what the sample constitutes: 111
A brief description of the sample: 111
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 111

Material Information

The concrete mix design number: 111
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 111
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: 111
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.