Sample Record
Owner Labs
- CT HQ - QASI Los Angeles Field Office
- CT D08 - Fontana Southern Regional Laboratory
DIME Sample ID 2017-11-02-1
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Project Information
| Project Identifiers | Project ID: 211616 DEA: 050G0404 EFIS: 0500020020 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO,MON-101-63.2/R69.3,R0.0/R1.9 |
| Award Date | 11/16/2016 |
| Closeout Date | 10/29/2020 |
| Work Description | ROADWAY REHABILITATION AND BRIDGE CONSTRUCTION. |
| Location Description | SAN LUIS OBISPO AND MONTERY COUNTIES NEAR PASO ROBLES FROM 0.5 MILE SOUTH OF SAN MARCOS CREEK BRIDGE TO 0.2 MILE SOUTH OF BRADLEY ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 09/15/2016) |
Sample Information
| Sample Taken Date | 11/02/2017 | Sample Unique Key | 1 |
|---|---|---|---|
| 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 | Not set |
| Sample type | Verification | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 3.58CY in Girder G22 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Weeks |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 951-258-8382 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | OLDCASTLE PRECAST PERRIS | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Br No 49 0164L | |
| Structure name | N San Miguel UC Widen |
Material Information
| Material Type | Concrete | The concrete mix design number | UV-273 |
|---|---|---|---|
| The truck number from where the sample was collected | NA | The batch plant ticket number from where the sample was collected | 56989 |
| Concrete batch plant | Onsite | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Casting Bed A2 | Where the material sample would have been placed if not sampled | Casting Bed A2 Girder G22 |
| 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: 2017-11-02-1-1 ASTM C39-17a (Verified)