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Sample Record for 2016-02-11-3

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

Project Information

DEA: No Project QA Service Level:
DIST-CO-RTE-PM: ---
Work Description: Special project identifier for material not associated with a project
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2016-02-11-3
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Verification
Type of Material: Concrete
Sample Taken Date: 02/11/2016
Date that the sample was received by the laboratory/organization performing the testing: 02/11/2016
The quantity of what the sample constitutes: snv
A brief description of the sample: snv
From where was the sample collected: Source
Laboratory sample identification: Unknown
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: snv

Material Information

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

Test Results