Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2017-07-21-7

Project Information

Project IdentifiersProject ID: 210696
DEA: 080M2804
EFIS: 0800000472
DIST-CO-RTE-PM08-SBD-15-171.8/173.8
Award Date11/04/2015
Closeout Date08/21/2018
Work DescriptionBRIDGE REPLACEMENT AND WIDEN, CONC AND HMA PVMT, COLD PLANE AC PVMT.
Location DescriptionIn SBD County
QA Service Level1 (Verified on 10/19/2015)

Sample Information

Sample Taken Date07/21/2017 Sample Unique Key7
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 testing07/26/2017
Sample typeQuality Assurance A brief description of the sample6x12
The quantity of what the sample constitutes8 From where was the sample collectedJob Site
First name of sampler or witnessed byABRAHAM Last name of sampler or witnessed byALMAW
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification942-21S2 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCALPORTLAND Transportation Laboratory (TL) Number20170721-S2
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierWHEATON WASH BRIDGE
Structure nameWHEATON WASH BRIDGE

Material Information

Material TypeConcrete The concrete mix design numberP40AF033
The truck number from where the sample was collected8063 The batch plant ticket number from where the sample was collectedS510351
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedTRUCK Where the material sample would have been placed if not sampledCENDA BRIDGE SOFFIT DIAPHRAGMS
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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