Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2019-02-26-1

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 Date02/26/2019 Sample Unique Key1
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 testing02/26/2019
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 byQuang Last name of sampler or witnessed byPham
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJobsite 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 number00000000000
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected00000000000
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