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Sample Record for 2021-10-05-18

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

Project Information

Project ID: 209820 DEA: 04297634 EFIS: 0415000040 COOP: 042548 QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-84,680-17.9/21
Work Description: ROUTE 84 WIDENING (4-LANE EXPRESSWAY) FROM I-680 TO PIGEON PASS, INCLUDING INTERSECTION, DRAINAGE IMPROVEMENTS AND UTILITY RELOCATION.
Location Description: ALAMEDA COUNTY IN AND NEAR SUNOL, PLEASANTON, AND LIVERMORE ON ROUTE 84 FROM 0.1 MILE EAST OF ROUTE 680 TO 0.1 MILE SOUTH OF RUBY HILL DRIVE AND ON ROUTE 680 FROM 1.2 MILES SOUTH TO 1.8 MILES NORTH OF ROUTE 84
Contractor Name: Bay Cities Paving & Grading
Contractor Address: 1450 Civic Ct. BLDG B #400, Concord CA, 94520
Resident Engineer: Hung Ngo Structure Rep.: Jordan Jarosz

Sample Information

DIME Sample ID: 2021-10-05-18
TL Number from the TL Form:
Sample Submitted By Organization: Forterra
Sample Organization Contact: 916-381-3910
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 10/05/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/07/2021
The quantity of what the sample constitutes: 8 Cylinders
A brief description of the sample: Dry Cast concrete sample
From where was the sample collected: Manufacturer
Laboratory sample identification: 10-6-2021
Structure unique identifier:
Structure name: Drainage System W1
The fabricator/manufacturer/facility name: Forterra Pipe and Precast, Florin Rd

Material Information

The concrete mix design number: MIX 5
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: NA
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: conveyor belt
Where the material sample would have been placed if not sampled: Box Culvert
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.