Sample Record

Owner Lab

  • CT SC Sub-unit 3672-104

DIME Sample ID 2018-11-14-4

Project Information

Project IdentifiersProject ID: 209384
DEA: 04264094
EFIS: 0400000735
COOP: 042531
DIST-CO-RTE-PM04-,SON--
Award Date01/21/2016
Closeout Date06/03/2020
Work DescriptionNot set
Location DescriptionNot set
QA Service Level1 (Verified on 06/03/2020)

Sample Information

Sample Taken Date11/14/2018 Sample Unique Key4
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 testing11/16/2018
Sample typeQuality Control A brief description of the sample6X12 cylinders
The quantity of what the sample constitutes163 Cy From where was the sample collectedSource
First name of sampler or witnessed byLha Last name of sampler or witnessed byKyi
Title of samplerASR Telephone number of sampler1-707-333-4263
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierRetaining Wall 3
Structure nameRetaining Wall 3

Material Information

Material TypeConcrete The concrete mix design number4201a
The truck number from where the sample was collected1435 The batch plant ticket number from where the sample was collected470906
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sample6X12 Cylinders
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampledretaining wall 3
From Lot No. Bag Lot No.

Submitted Tests

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