Sample Record

Owner Lab

  • CT D01 - Field Laboratory

DIME Sample ID 2018-07-13-11

Project Information

Project IdentifiersProject ID: 212247
DEA: 010G8004
MINOR: 01A1727
DIST-CO-RTE-PM01-MEN-1-78.0/83.5, 77.0/83.5
Award Date01/11/2017
Closeout Date04/12/2021
Work DescriptionMajor Damage Restoration
Location DescriptionIn Mendocino County near West port from 0.3 mile south of Wages Creek Bridge #10-137 to Solider Point Viaduct #10-271
QA Service Level1 (Verified on 03/21/2017)

Sample Information

Sample Taken Date07/13/2018 Sample Unique Key11
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 testing08/15/2018
Sample typeQuality Assurance A brief description of the sampleConcrete 6 x 12 Cylinders
The quantity of what the sample constitutesOne Day of Concrete Pour From where was the sample collectedJob Site
First name of sampler or witnessed bys Last name of sampler or witnessed bysami
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameunknown 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 numbernot available
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected01
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedchute 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.