Sample Record
Owner Lab
- CT SC - 3672 - Petaluma
DIME Sample ID 2018-11-14-4
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 209384 DEA: 04264094 EFIS: 0400000735 COOP: 042531 |
|---|---|
| DIST-CO-RTE-PM | 04-,SON-- |
| Award Date | 01/21/2016 |
| Closeout Date | 06/03/2020 |
| Work Description | Not set |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/03/2020) |
Sample Information
| Sample Taken Date | 11/14/2018 | Sample Unique Key | 4 |
|---|---|---|---|
| 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 testing | 11/16/2018 |
| Sample type | Quality Control | A brief description of the sample | 6X12 cylinders |
| The quantity of what the sample constitutes | 163 Cy | From where was the sample collected | Source |
| First name of sampler or witnessed by | Lha | Last name of sampler or witnessed by | Kyi |
| Title of sampler | ASR | Telephone number of sampler | 1-707-333-4263 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock Materials | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Retaining Wall 3 | |
| Structure name | Retaining Wall 3 |
Material Information
| Material Type | Concrete | The concrete mix design number | 4201a |
|---|---|---|---|
| The truck number from where the sample was collected | 1435 | The batch plant ticket number from where the sample was collected | 470906 |
| Concrete batch plant | Shamrock Materials | The fabricator/manufacturer designation for the sample | 6X12 Cylinders |
| A detailed description of where the material sample was collected | Chute | Where the material sample would have been placed if not sampled | retaining wall 3 |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||