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

Sample Record for 2020-05-22-16


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: 2020-05-22-16
TL Number from the TL Form:
Sample Submitted By Organization: ZZCT - Sacramento DIME Development-AVS Testing Internal
Sample Organization Contact:
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/22/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/22/2020
The quantity of what the sample constitutes: 2 Concrete Cylinders
A brief description of the sample: Precast Concrete Cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: CTP70-V41
The truck number from where the sample was collected: Unknown
The batch plant ticket number from where the sample was collected: 1234
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: concrete sample from wheel barrow
Where the material sample would have been placed if not sampled: Unknown
From Lot No.: Unknown
Bag Lot No.: Unknown