Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2019-10-21-5
Project Information
Project Identifiers | Project ID: 213702 DEA: 041G4304 EFIS: 0412000126 |
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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 | 10/21/2019 | Sample Unique Key | 5 |
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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 | 10/22/2019 |
Sample type | Quality Assurance | A brief description of the sample | 4"x8" Cylinders |
The quantity of what the sample constitutes | 3 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 | 2019-10-16-2b | 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 |
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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 |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |