Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2017-08-30-3

Project Information

Project IdentifiersProject ID: 211162
DEA: 044G4504
EFIS: 0412000477
DIST-CO-RTE-PM04-SOL-780-7.07
Award Date02/01/2017
Closeout Date11/15/2019
Work DescriptionREPLACE BRIDGE TO PROVIDE STANDARD VERTICAL CLEARANCE
Location DescriptionLAUREL STREET OC
QA Service Level1 (Verified on 05/20/2016)

Sample Information

Sample Taken Date08/30/2017 Sample Unique Key3
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 testing09/01/2017
Sample typeQuality Assurance A brief description of the samplegrout
The quantity of what the sample constitutes6 From where was the sample collectedJob Site
First name of sampler or witnessed byWilliam Last name of sampler or witnessed bySommer
Title of samplerUnknown Telephone number of sampler7075150854
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRNR Construction Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeCementitious Brandus spec
Millunknown Type of Cementitious MaterialType II/V Cement

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments