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Sample Record for 2021-02-16-5

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

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, Roseville, CA 95661
Resident Engineer: Girmay Beyene Structure Rep.: Guzman, Luis

Sample Information

DIME Sample ID: 2021-02-16-5
TL Number from the TL Form: 12345
Sample Submitted By Organization: CT HQ - Sacramento Cement Testing Laboratory
Sample Organization Contact: (916) 227-7071
Type of Sample: Quality Control
Type of Material: Cementitious
Sample Taken Date: 02/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/16/2021
The quantity of what the sample constitutes: 1
A brief description of the sample: testing 123456
From where was the sample collected: Other
Laboratory sample identification:
Structure unique identifier: 34-0003
Structure name: bob
The fabricator/manufacturer/facility name: nowhere

Material Information

Brand: Ralph Lauren
Mill: oats
Type of Cementitious Material: Type II/V Cement

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.