Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2018-08-15-6

Project Information

Project IdentifiersProject ID: 212743
DEA: 030H26U4
EFIS: 0317000247
DIST-CO-RTE-PM03-PLA-65-R5.0/R6.6
Award Date02/14/2018
Closeout Date10/21/2022
Work DescriptionNORTHBOUND WIDENING AND RAMP IMPROVEMENTS.
Location DescriptionPLACER COUNTY IN AND NEAR ROSEVILLE AND ROCKLIN FROM 0.1 MILE SOUTH OF EAST ROSEVILLE VIADUCT TO 0.5 MILE SOUTH OF PLEASANT GROVE BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 12/18/2017)

Sample Information

Sample Taken Date08/15/2018 Sample Unique Key6
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 testing08/16/2018
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutestwo cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byshe Last name of sampler or witnessed byvang
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJobsite Transportation Laboratory (TL) Number173109
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design number1604354
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected0000000
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedJobsite 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 Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments