Sample Record

Owner Labs

  • CT QASI - Los Angeles Field Laboratory
  • CT - Southern Regional Laboratory

DIME Sample ID 2017-11-02-1

Project Information

Project IdentifiersProject ID: 211616
DEA: 050G0404
EFIS: 0500020020
DIST-CO-RTE-PM05-SLO,MON-101-63.2/R69.3,R0.0/R1.9
Award Date11/16/2016
Closeout Date10/29/2020
Work DescriptionROADWAY REHABILITATION AND BRIDGE CONSTRUCTION.
Location DescriptionSAN 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 Level1 (Verified on 09/15/2016)

Sample Information

Sample Taken Date11/02/2017 Sample Unique Key1
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 typeVerification A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes3.58CY in Girder G22 From where was the sample collectedFabricator
First name of sampler or witnessed byDavid Last name of sampler or witnessed byWeeks
Title of samplerCT METS QA INSPECTOR Telephone number of sampler951-258-8382
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameOLDCASTLE PRECAST PERRIS Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierBr No 49 0164L
Structure nameN San Miguel UC Widen

Material Information

Material TypeConcrete The concrete mix design numberUV-273
The truck number from where the sample was collectedNA The batch plant ticket number from where the sample was collected56989
Concrete batch plantOnsite The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCasting Bed A2 Where the material sample would have been placed if not sampledCasting Bed A2 Girder G22
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2017-11-02-1-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensMatthew ClaytonCT - Southern Regional Laboratory11/09/2017Matthew Clayton
Yes
11/09/2017