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Sample Record for 2013-11-04-11101891

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

Project Information

Project ID: 8127 DEA: 080N5904 EFIS: 0800000533 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-40-R85.2
Work Description: CONSTRUCT PC/PS BULB-TEE GIRDER BRIDGE
Location Description: SAN BERNARDINO COUNTY NEAR ESSEX AT VAN WINKLE WASH BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: P.O. Box 50085, Watsonville, CA 95077
Resident Engineer: Khoa Nguyen Structure Rep.: Ching Chuang

Sample Information

DIME Sample ID: 2013-11-04-11101891
TL Number from the TL Form:
Sample Submitted By Organization: SCST, LLC.
Sample Organization Contact: (619) 280-4321
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 11/04/2013
Date that the sample was received by the laboratory/organization performing the testing: 11/05/2013
The quantity of what the sample constitutes: 4 concrete cylinders
A brief description of the sample: concrete cylinders
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Hi-Grade Concrete Supplier

Material Information

The concrete mix design number: SITI72SK-4500
The truck number from where the sample was collected: 184
The batch plant ticket number from where the sample was collected: 812363
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Transition Slabs at Eastern and Western Ends of the 9-inch Deck Pour
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.