Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2017-04-17-6
Project Information
Project Identifiers | Project ID: 212036 DEA: 044K2404 EFIS: 0417000284 |
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DIST-CO-RTE-PM | 04-MRN,MRN-1-10.9, 10.8/10.9, 10.90, 6.6/10.9 |
Award Date | 01/31/2017 |
Closeout Date | 10/17/2022 |
Work Description | Construct Solier Pile Wall |
Location Description | Not set |
QA Service Level | 1 (Verified on 03/17/2017) |
Sample Information
Sample Taken Date | 04/17/2017 | Sample Unique Key | 6 |
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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 | 05/16/2017 |
Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | 2 6x12 concrete cylinders | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Harry | Last name of sampler or witnessed by | Suryantoro |
Title of sampler | Transportation Engineer | Telephone number of sampler | 1-707-333-4263 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name | Retaining Wall |
Material Information
Material Type | Concrete | The concrete mix design number | 4700P |
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The truck number from where the sample was collected | 1808 | The batch plant ticket number from where the sample was collected | 153921 |
Concrete batch plant | 1 | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | Mix Truck Chute | Where the material sample would have been placed if not sampled | soldier pile wall |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2017-04-17-6-1 ASTM C39-17a (Verified)