Sample Record

Owner Lab

  • CT SC Sub-unit 3672-104

DIME Sample ID 2017-05-23-8

Project Information

Project IdentifiersProject ID: 211853
DEA: 042G8904
EFIS: 0400021259
DIST-CO-RTE-PM04-MRN-1-8.0
Award Date02/09/2017
Closeout Date12/22/2017
Work DescriptionSOLDIER PILE WALL WITH TIEBACKS AND EMBANKMENT CONFINED SYSTEM.
Location DescriptionMARIN COUNTY NEAR MUIR BEACH AT 2.1 MILES NORTH OF MUIR WOODS ROAD
QA Service Level1 (Verified on 03/15/2017)

Sample Information

Sample Taken Date05/23/2017 Sample Unique Key8
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 testingNot set
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 6x12 concrete cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byJanine Last name of sampler or witnessed bymarr
Title of samplerTransportation Engineer Telephone number of sampler1-510-385-6764
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameRetaining Wall Ground Anchor

Material Information

Material TypeConcrete The concrete mix design number4201a
The truck number from where the sample was collected1208 The batch plant ticket number from where the sample was collected154830
Concrete batch plant1 The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedMix Truck Chute Where the material sample would have been placed if not sampledjobsite
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.