Sample Record

Owner Lab

  • CT SC - 3672 - Richmond

DIME Sample ID 2018-08-03-17

Project Information

Project IdentifiersProject ID: 212351
DEA: 040P1304
DIST-CO-RTE-PM04-MRN-1-11.5, 11.50, 11.5, 12
Award Date06/09/2017
Closeout Date09/24/2018
Work DescriptionConstruct Soldier Pile Wall with Tiebacks
Location DescriptionRoute 1 PM 11.5
QA Service Level1 (Verified on 07/24/2017)

Sample Information

Sample Taken Date08/03/2018 Sample Unique Key17
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 testing08/10/2018
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 concrete cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byHla Last name of sampler or witnessed byKYI
Title of samplerTE Civil Telephone number of sampler(415)260-7911
Laboratory sample identification212351 Linked DIME Sample ID212351
The fabricator/manufacturer/facility nameShamrock Transportation Laboratory (TL) NumberTL-0502
Inspector Lot Number from the Transportation Laboratory (TL) FormTL-0502 Structure unique identifier27E0074
Structure nameConstruct Soldier Pile Wall with Tiebacks

Material Information

Material TypeConcrete The concrete mix design number3172GG
The truck number from where the sample was collected1439 The batch plant ticket number from where the sample was collected466645
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sampleShamrock
A detailed description of where the material sample was collectedfrom chute Where the material sample would have been placed if not sampledRW2 Tier 4
From Lot No.Unknown Bag Lot No.Unknown

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.

Sample File Attachments

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Test File Attachments