Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2019-10-16-8
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213702 DEA: 041G4304 EFIS: 0412000126 |
|---|---|
| DIST-CO-RTE-PM | 04-NAP-128-R7.4 |
| Award Date | 03/29/2019 |
| Closeout Date | 12/08/2022 |
| Work Description | REPLACE BRIDGE, HMA PAVING, DRAINAGE AND RSP |
| Location Description | NAPA COUNTY NEAR SAINT HELENA AT CONN CREEK |
| QA Service Level | 1 (Verified on 07/29/2019) |
Sample Information
| Sample Taken Date | 10/16/2019 | Sample Unique Key | 8 |
|---|---|---|---|
| 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 testing | 10/17/2019 |
| Sample type | Quality Assurance | A brief description of the sample | 6"x12" Cylinders |
| The quantity of what the sample constitutes | 2 Cylinders | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Andre | Last name of sampler or witnessed by | Totari |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 2019-10-16-1 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Kie-Con Antioch | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | K5060-502a |
|---|---|---|---|
| The truck number from where the sample was collected | Unknown | The batch plant ticket number from where the sample was collected | Unknown |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | Kie-Con | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||