Sample Record
Owner Lab
- CT D05 - Whitley Gardens Field Laboratory
DIME Sample ID 2025-02-07-12
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994443 DEA: 053307C4 EFIS: 0514000028 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO-41,46-44.5/45.3,54.0/57.8 |
| Award Date | 02/27/2023 |
| Closeout Date | Not set |
| Work Description | Wye Segment - Route 41/46 Separation |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 12/16/2022) |
Sample Information
| Sample Taken Date | 02/07/2025 | Sample Unique Key | 12 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 02/08/2025 |
| Sample type | Acceptance | A brief description of the sample | 3x 4x8 cylinders 590RM1010 |
| The quantity of what the sample constitutes | 30 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Will | Last name of sampler or witnessed by | Wojdylak |
| Title of sampler | CT Tester | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CalPortland Paso Robles | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | OHSS#5 CIDH |
Material Information
| Material Type | Concrete | The concrete mix design number | 590RM1010 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | NA | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Mix Truck | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2025-02-07-12-1 CTM 521-June 2020 (Verified)