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Sample Record for 2015-12-16-3

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

Project Information

Project ID: 209795 DEA: 08383504 EFIS: 0800000638 QA Service Level: 1
DIST-CO-RTE-PM: 08-RIV-74-63.0
Work Description: REPLACE HURKEY CREEK BRIDGE
Location Description: RIVERSIDE COUNTY NEAR IDYLLWILD AT HURKEY CREEK BRIDGE
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 440 SOUTH MELROSE DRIVE 200 , VISTA CA 92081
Resident Engineer: Max Quach Structure Rep.: Shukri Abouazra

Sample Information

DIME Sample ID: 2015-12-16-3
TL Number from the TL Form: 106123
Sample Submitted By Organization: CT - Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Quality Control
Type of Material: Concrete
Sample Taken Date: 12/16/2015
Date that the sample was received by the laboratory/organization performing the testing: 12/18/2015
The quantity of what the sample constitutes: 2
A brief description of the sample: 6X12
From where was the sample collected: Job Site
Laboratory sample identification: 918-23
Structure unique identifier: HURKEY CREEK BRIDGE
Structure name: ABUT 2
The fabricator/manufacturer/facility name: NP

Material Information

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

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.