Sample Record
Owner Labs
- CT SC - 3672 - Petaluma
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2017-08-02-10
Project Information
Project Identifiers | Project ID: 210871 DEA: 044G4604 EFIS: 0412000480 |
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DIST-CO-RTE-PM | 04-MRN-101-1.5/14.0 |
Award Date | 01/28/2016 |
Closeout Date | 10/17/2019 |
Work Description | REMOVE EXISTING AND CONSTRUCT NEW BRIDGE RAILINGS. |
Location Description | IN MARIN COUNTY, AT VARIOUS LOCATION, FROM SPENCER AVE OVERCROSSING TO NORTH BRANCHGALLINAS CREEK BRIDGE |
QA Service Level | 1 (Verified on 01/12/2016) |
Sample Information
Sample Taken Date | 08/02/2017 | Sample Unique Key | 10 |
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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 | 08/23/2017 |
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 | ASR AND SR | Telephone number of sampler | 1-707-333-4263 |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Shamrock Materials | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 4201A | |
Structure name | Corte Madera Creek Bridge |
Material Information
Material Type | Concrete | The concrete mix design number | 4201a |
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The truck number from where the sample was collected | 1208 | The batch plant ticket number from where the sample was collected | 59834 |
Concrete batch plant | Shamrock San Rafael | The fabricator/manufacturer designation for the sample | |
A detailed description of where the material sample was collected | truck chute | Where the material sample would have been placed if not sampled | concrete barrier |
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: 2017-08-02-10-1 ASTM C39-10 (Verified)