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Sample Record for 2014-07-30-5304340

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

Project Information

Project ID: 209175 DEA: 030F2204 EFIS: 0300000072 QA Service Level: 1
DIST-CO-RTE-PM: 03-ED-50-R30.7/R31.7
Work Description: REPLACE BRIDGE.
Location Description: SLY PARK UNDERCROSSING
Contractor Name: Viking Construction Company
Contractor Address: P.O. Box 1508 , Rancho Cordova, CA 95741
Resident Engineer: Jarrett Woodruff Structure Rep.: Miller, Brandon

Sample Information

DIME Sample ID: 2014-07-30-5304340
TL Number from the TL Form:
Sample Submitted By Organization: Viking Construction Company, Inc. - Rancho Cordova
Sample Organization Contact: (916) 852-5530
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 07/30/2014
Date that the sample was received by the laboratory/organization performing the testing: 07/30/2014
The quantity of what the sample constitutes: 6 cylinders
A brief description of the sample: Approach Slab Concrete
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Folsom Ready Mix

Material Information

The concrete mix design number: SF718AFST0
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 1047146
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: Folsom Ready Mix Stockpile
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.