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

Sample Record for 2015-02-05-1


Project Information

Project ID: 7547 DEA: 103A1004 EFIS: 1000000409 QA Service Level: 1
DIST-CO-RTE-PM: 10-SJ-4,99-R19.5/R20.1,15.0/18.6
Work Description: WIDEN FREEWAY, CONSTRUCT BRIDGES, PUMP PLANTS AND INTERCHANGES.
Location Description: SAN JOAQUIN COUNTY IN AND NEAR STOCKTON ON ROUTE 4 FROM ADELBERT AVENUE TO 0.1 MILE WEST OF GOLDEN GATE AVENUE OVERCROSSING AND ON ROUTE 99 FROM 0.4 MILE NORTH OF ARCH ROAD UNDERCROSSING TO 0.1 MILE SOUTH OF ROUTE 4 WEST/99 NORTH CONNECTOR OVERCROSSING
Contractor Name: Myers and Sons Contractor Address: 4600 NORTHGATE BLVD, STE 100
Resident Engineer: Troy Scheiber Structure Rep.: Ha, Chau

Sample Information

DIME Sample ID: 2015-02-05-1
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Sample Organization Contact: 7146885366
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 02/05/2015
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 4 cylinders
A brief description of the sample: concrete cylinders
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: 1111121
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: s5yrgt
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: column 1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.:

Test Results

Test 1 of 1

DIME Test ID: 2015-02-05-1-3
Test Method: ASTM C143-10a: Standard Test Method for Slump of Hydraulic-Cement Concrete
Data has not been verified.