Sample Record

Owner Lab

  • Caltrans Vallejo Field Laboratory

DIME Sample ID 2017-08-21-18

Project Information

Project IdentifiersProject ID: 211778
DEA: 04235654
EFIS: 0400000680
DIST-CO-RTE-PM04-SM-101,114-1.3/2.5,5.0/5.3
Award Date02/10/2017
Closeout Date01/08/2020
Work DescriptionRECONSTRUCT INTERCHANGE
Location DescriptionSAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET
QA Service Level1 (Verified on 10/24/2016)

Sample Information

Sample Taken Date08/21/2017 Sample Unique Key18
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 testing08/29/2017
Sample typeInformational A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedFabricator
First name of sampler or witnessed byStacey Last name of sampler or witnessed byDavis
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility namekiecon Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberct60vt2
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedunk
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedfabricator Where the material sample would have been placed if not sampledUnknown
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

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