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Sample Record for 2021-05-18-54

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

Project Information

Project ID: 214469 DEA: 030H08U4 EFIS: 0319000029 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-50-L0.2/R6.1
Work Description: Sac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location Description: FROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
Contractor Name: FLATIRON WEST INC
Contractor Address: 2100 Goodyear Rd., Benicia, CA 94510
Resident Engineer: Rodney Murphy Structure Rep.: Ken Haas

Sample Information

DIME Sample ID: 2021-05-18-54
TL Number from the TL Form:
Sample Submitted By Organization: Kie-Con, Inc.
Sample Organization Contact: (925) 754-9494
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 05/18/2021
Date that the sample was received by the laboratory/organization performing the testing: 05/19/2021
The quantity of what the sample constitutes: 37.5 CY
A brief description of the sample: 6x12 concrete cylinders
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: KIE-CON, INC

Material Information

The concrete mix design number: CTP70-V41
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 110189
Concrete batch plant:
The fabricator/manufacturer designation for the sample: 3S 5/18/21
A detailed description of where the material sample was collected: Concrete sample from wheelbarrow
Where the material sample would have been placed if not sampled: 14 Inch Square Pile
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.