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

Sample Record for 2020-05-26-6


Project Information

Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-5-9.7/24.9
Work Description:
Location Description: Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct
Contractor Name: NOR CAL PAVING TEICHERT/GRANITE Contractor Address: 400 Sunrise Ave. Ste. #300
Resident Engineer: Girmay Beyene Structure Rep.: Ha, Chau

Sample Information

DIME Sample ID: 2020-05-26-6
TL Number from the TL Form:
Sample Submitted By Organization: Caltrans Vallejo Field Laboratory
Sample Organization Contact: (510) 774-6009
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 05/26/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/27/2020
The quantity of what the sample constitutes: 2 - 6x12 cylinders
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: K6080-603
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 0
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: Kie-Con Antioch
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown