Sample Record

Owner Lab

  • Caltrans Vallejo Field Laboratory

DIME Sample ID 2019-10-16-8

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 Date10/16/2019 Sample Unique Key8
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 testing10/17/2019
Sample typeQuality Assurance A brief description of the sample6"x12" Cylinders
The quantity of what the sample constitutes2 Cylinders From where was the sample collectedFabricator
First name of sampler or witnessed byAndre Last name of sampler or witnessed byTotari
Title of sampler Telephone number of sampler
Laboratory sample identification2019-10-16-1 Linked DIME Sample ID
The fabricator/manufacturer/facility nameKie-Con Antioch Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberK5060-502a
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 collectedKie-Con 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.