Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2020-05-28-25
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Project Information
| Project Identifiers | Project ID: 214601 DEA: 041J5694 EFIS: 0419000313 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-0.0/21.8 |
| Award Date | 12/03/2019 |
| Closeout Date | 09/28/2022 |
| Work Description | San Mateo US 101 Express Lanes North |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 05/28/2020 | Sample Unique Key | 25 |
|---|---|---|---|
| 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 | 05/28/2020 |
| Sample type | Quality Control | A brief description of the sample | Precast concrete |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | ESTUARDO | Last name of sampler or witnessed by | RAMIREZ |
| Title of sampler | QCM | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | KIE-CON, INC | 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 | CTP70-V41 |
|---|---|---|---|
| The truck number from where the sample was collected | Unknown | The batch plant ticket number from where the sample was collected | 104723 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | Concrete sample from wheelbarrow | 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: 2020-05-28-25-1 ASTM C39-17a (Verified)