Sample Record
Owner Lab
- CT SC - 3672 - Fairfield
DIME Sample ID 2017-03-15-9
Project Information
Project Identifiers | Project ID: 211997 DEA: 044K1504 EFIS: 0417000271 COOP: 250 |
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DIST-CO-RTE-PM | 04-MRN-1-4.0/8.0, 4.0/5.0 |
Award Date | 01/03/2017 |
Closeout Date | 12/20/2017 |
Work Description | const SPW and replace culvert |
Location Description | Not set |
QA Service Level | 1 (Verified on 02/03/2017) |
Sample Information
Sample Taken Date | 03/15/2017 | Sample Unique Key | 9 |
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Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 04/03/2017 |
Sample type | Quality Assurance | A brief description of the sample | 2 6x12 concrete cylinders |
The quantity of what the sample constitutes | 30 CY | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Janine | Last name of sampler or witnessed by | Marr |
Title of sampler | Unknown | Telephone number of sampler | Unknown |
Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | Unknown |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
Structure name | Unknown |
Material Information
Material Type | Concrete | The concrete mix design number | 4201A |
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The truck number from where the sample was collected | 1298 | The batch plant ticket number from where the sample was collected | 152103 |
Concrete batch plant | 01 | The fabricator/manufacturer designation for the sample | Unknown |
A detailed description of where the material sample was collected | CHUTE FROM TRUCK | Where the material sample would have been placed if not sampled | soldier pile wall |
From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |