Sample Record

Owner Lab

  • CT SC Sub-unit 3676-106

DIME Sample ID 2019-08-27-3

Project Information

Project IdentifiersProject ID: 213702
DEA: 041G4304
EFIS: 0412000126
DIST-CO-RTE-PM04-NAP-128-R7.4
Award Date04/22/2019
Closeout DateNot set
Work DescriptionREPLACE BRIDGE, HMA PAVING, DRAINAGE AND RSP
Location DescriptionNAPA COUNTY NEAR SAINT HELENA AT CONN CREEK
QA Service Level1 (Verified on 07/29/2019)

Sample Information

Sample Taken Date08/27/2019 Sample Unique Key3
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 testing09/04/2019
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes4 Cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byNana Last name of sampler or witnessed byBudu
Title of samplerUnknown Telephone number of sampler510-867-4517
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameShamrock Materials Transportation Laboratory (TL) Number28 - Napa
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier21-0115
Structure nameConn Creek Bridge Abut 1 Pile 5

Material Information

Material TypeConcrete The concrete mix design number4700
The truck number from where the sample was collected1956 The batch plant ticket number from where the sample was collected730160
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sampleShamrock Materials
A detailed description of where the material sample was collectedBack of Truck 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.