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

Sample Record for 2015-06-09-1


Project Information

Project ID: 7285 DEA: 040120T4 EFIS: 0400000027 QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-80-12.6/13.9
Work Description: CONSTRUCT BRIDGE, ROADWAYS, ELECTRICAL, BUILDINGS AND REMOVE BRIDGES
Location Description: THE CITY AND COUNTY OF SAN FRANCISCO FROM THE YERBA BUENA TUNNEL TO 1.3 KM EAST OF THE YERBA BUENA TUNNEL
Contractor Name: CALIFORNIA ENGINEERING CONTRACTORS INC/ SILVERADO CONTRACTORS INC VENTURE Contractor Address: 20 HAPPY VALLEY ROAD
Resident Engineer: Bill Howe Structure Rep.: Ardakanian, Mehran

Sample Information

DIME Sample ID: 2015-06-09-1
TL Number from the TL Form:
Sample Submitted By Organization: CT YBITS2 - Oakland Field Laboratory
Sample Organization Contact: (510) 286-4247
Type of Sample: Acceptance
Type of Material: Concrete
Sample Taken Date: 06/09/2015
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 288
A brief description of the sample: Bike Path Span 5 Beam 17 thru 20
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

The concrete mix design number: D101C5E1
The truck number from where the sample was collected:
The batch plant ticket number from where the sample was collected: 18027996
Concrete batch plant:
The fabricator/manufacturer designation for the sample:
A detailed description of where the material sample was collected: near E1
Where the material sample would have been placed if not sampled:
From Lot No.:
Bag Lot No.: