Sample Record

Owner Lab

  • SCST, LLC.

DIME Sample ID 2013-11-04-11101891

Project Information

Project IdentifiersProject ID: 8127
DEA: 080N5904
EFIS: 0800000533
DIST-CO-RTE-PM08-SBD-40-R85.2
Award Date02/07/2013
Closeout Date05/11/2015
Work DescriptionCONSTRUCT PC/PS BULB-TEE GIRDER BRIDGE
Location DescriptionSAN BERNARDINO COUNTY NEAR ESSEX AT VAN WINKLE WASH BRIDGE
QA Service Level1 (Verified on 12/10/2012)

Sample Information

Sample Taken Date11/04/2013 Sample Unique Key11101891
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 testing11/05/2013
Sample typeQuality Control A brief description of the sampleconcrete cylinders
The quantity of what the sample constitutes4 concrete cylinders From where was the sample collectedSource
First name of sampler or witnessed byJared Last name of sampler or witnessed byTietjen
Title of samplerField Technician Telephone number of samplerNot set
Laboratory sample identificationNot set Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameHi-Grade Concrete Supplier Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeConcrete The concrete mix design numberSITI72SK-4500
The truck number from where the sample was collected184 The batch plant ticket number from where the sample was collected812363
Concrete batch plantNot set The fabricator/manufacturer designation for the sampleNot set
A detailed description of where the material sample was collectedTransition Slabs at Eastern and Western Ends of the 9-inch Deck Pour Where the material sample would have been placed if not sampledNot set
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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