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

Sample Record for 2020-03-16-4


Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2020-03-16-4
TL Number from the TL Form:
Sample Submitted By Organization: CT QAM - Sacramento Field Laboratory
Sample Organization Contact: (916) 227-7266
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 03/16/2020
Date that the sample was received by the laboratory/organization performing the testing: 03/16/2020
The quantity of what the sample constitutes: 250 cy
A brief description of the sample: concrete
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:

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: 325445
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: 131325
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