Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2018-09-24-13

Project Information

Project IdentifiersProject ID: 211778
DEA: 04235654
EFIS: 0400000680
DIST-CO-RTE-PM04-SM-101,114-1.3/2.5,5.0/5.3
Award Date02/10/2017
Closeout Date01/08/2020
Work DescriptionRECONSTRUCT INTERCHANGE
Location DescriptionSAN MATEO COUNTY AT VARIOUS LOCATIONS ON ROUTE 101 FROM 0.4 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.6 MILE SOUTH OF HENDERSON UNDERPASS AND ON ROUTE 114 FROM WILLOW ROAD SEPARATION TO NEWBRIDGE STREET
QA Service Level1 (Verified on 10/24/2016)

Sample Information

Sample Taken Date09/24/2018 Sample Unique Key13
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 testing09/25/2018
Sample typeQuality Assurance A brief description of the sampleConcrete 6 x 12
The quantity of what the sample constitutes2 From where was the sample collectedSource
First name of sampler or witnessed bystacey Last name of sampler or witnessed bydavis
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namekiecon Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberk6080-603
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedunknown
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedfabricator 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
2018-09-24-13-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensWilliam Sommer, CT HQ - QASI Bay Area Field Office10/22/2018William Sommer
No
Info

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2018-09-24-13-1 ASTM C39-10