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Sample Record for 2016-08-20-1

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

Project Information

Project ID: 208714 DEA: 08043514 EFIS: 0800000010 QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-58-R22.2/R31.1
Work Description: REALIGN AND WIDEN 2 TO 4 LANES EXPRESSWAY
Location Description: HINKLEY ROAD FROM 2.4 MILES WEST OF HIDDEN RIVER ROAD TO? 0.7 MILE EAST OF LENWOOD ROAD.
Contractor Name: Skanska Civil USA
Contractor Address: 1995 Agua Mansa Road, Riverside, CA 92509
Resident Engineer: Shaine Shahidi Structure Rep.: Ahmad Ankir

Sample Information

DIME Sample ID: 2016-08-20-1
TL Number from the TL Form: Unknown
Sample Submitted By Organization: CT D08 - Barstow Field Testing Laboratory
Sample Organization Contact: (760) 843-4173
Type of Sample: Quality Assurance
Type of Material: Concrete
Sample Taken Date: 08/20/2016
Date that the sample was received by the laboratory/organization performing the testing: 08/30/2016
The quantity of what the sample constitutes: 1
A brief description of the sample: beam 39C EB Lane 2 station 1230.00
From where was the sample collected: Job Site
Laboratory sample identification: beam 39 C
Structure unique identifier: Unknown
Structure name: Unknown
The fabricator/manufacturer/facility name: Teichert

Material Information

The concrete mix design number: LB15-0065RM
The truck number from where the sample was collected: 10
The batch plant ticket number from where the sample was collected: 10
Concrete batch plant: Unknown
The fabricator/manufacturer designation for the sample: Unknown
A detailed description of where the material sample was collected: from mix truck
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.