Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2020-10-22-12
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Project Information
| Project Identifiers | Project ID: 213653 DEA: 044G8204 EFIS: 0413000049 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-10.6/10.8 |
| Award Date | 05/05/2020 |
| Closeout Date | 08/14/2023 |
| Work Description | REPLACE SAN RAFAEL HARBOR BRIDGE (ABC) |
| Location Description | MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET |
| QA Service Level | 1 (Verified on 05/31/2019) |
Sample Information
| Sample Taken Date | 10/22/2020 | 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 | 10/23/2020 |
| Sample type | Quality Control | A brief description of the sample | 1 inch Rock cement and slag mix |
| The quantity of what the sample constitutes | 3.3 CY | From where was the sample collected | Manufacturer |
| 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 | PRECAST MOCK UP |
Material Information
| Material Type | Concrete | The concrete mix design number | K4500x |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 108214 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | concrete sample from wheelb barrow | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-10-22-12-1 ASTM C39-18 (Verified)
DIME Test ID: 2020-10-22-12-2 ASTM C39-18 (Verified)