Sample Record
Owner Labs
- CT HQ - QASI Sacramento Field Office
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2019-11-14-12
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Project Information
| Project Identifiers | Project ID: 214167 DEA: 043Q0504 EFIS: 0419000141 |
|---|---|
| DIST-CO-RTE-PM | 04-CC-4-24.9/27, 24.9/27.0 |
| Award Date | 04/09/2019 |
| Closeout Date | 03/04/2021 |
| Work Description | Injection grouting and replace PCC slabs |
| Location Description | In Pittsburgh and Antioch, from 0.1 mile west of Century Blvd to 0.1 mile east of Conta Loma Blvd |
| QA Service Level | 1 (Verified on 09/16/2019) |
Sample Information
| Sample Taken Date | 11/14/2019 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 11/15/2019 |
| Sample type | Quality Assurance | A brief description of the sample | 4x8 concrete cylinders (3 total) |
| The quantity of what the sample constitutes | mix design ver-85-lv | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Ryan | Last name of sampler or witnessed by | Cummings |
| Title of sampler | CT METS QA INSPECTOR | Telephone number of sampler | 209-662-3492 |
| Laboratory sample identification | Linked DIME Sample ID | 2019-11-14-11 | |
| The fabricator/manufacturer/facility name | ConFab Lathrop | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | S29-171-19 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | VER-85LV |
|---|---|---|---|
| The truck number from where the sample was collected | 3 | The batch plant ticket number from where the sample was collected | 4879 |
| Concrete batch plant | onsite Conco | The fabricator/manufacturer designation for the sample | ConFab |
| A detailed description of where the material sample was collected | Form 2 | Where the material sample would have been placed if not sampled | Unknown |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-11-14-12-2 ASTM C39-17a (Verified)