Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2020-10-13-12

Sample is locked from editing.

Project Information

Project IdentifiersProject ID: 215055
DEA: 042AC204
EFIS: 0420000119
DIST-CO-RTE-PM04-MRN-1-8.5
Award Date07/06/2020
Closeout DateNot set
Work DescriptionSOLDIER PILE WALL (REPAIR)
Location DescriptionNEAR STINSON BEACH FROM COLD STREAM TO 0.2 MILE SOUTH OF LONE TREE CREEK
QA Service Level1 (Verified on 07/01/2020)

Sample Information

Sample Taken Date10/13/2020 Sample Unique Key12
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 testing10/23/2020
Sample typeQuality Assurance A brief description of the sampleCylinders
The quantity of what the sample constitutes16cy From where was the sample collectedJob Site
First name of sampler or witnessed byJanine Last name of sampler or witnessed byMarr
Title of samplerStructure Rep Telephone number of sampler510-385-6764
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name27-E0015

Material Information

Material TypeConcrete The concrete mix design number3876
The truck number from where the sample was collected1446 The batch plant ticket number from where the sample was collected1191186
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampledRetaining wall
From Lot No. Bag Lot No.

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