Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2014-02-26-12004457
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Project Information
| Project Identifiers | Project ID: 208572 DEA: 100L3304 EFIS: 1000000100 COOP: 10355 Permit Numbers: 1012NMC0508 |
|---|---|
| DIST-CO-RTE-PM | 10-STA-99-0.0/0.3 |
| Award Date | Not set |
| Closeout Date | 03/09/2020 |
| Work Description | Reconsteuct SR99/Kiernan Interchange |
| Location Description | City of Salida, in STA County |
| QA Service Level | 1 (Verified on 03/25/2013) |
Sample Information
| Sample Taken Date | 02/26/2014 | Sample Unique Key | 12004457 |
|---|---|---|---|
| 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 | 02/27/2014 |
| Sample type | Informational | A brief description of the sample | Mix Design K6090-621SCC |
| The quantity of what the sample constitutes | 2 concrete cylinders | From where was the sample collected | Source |
| First name of sampler or witnessed by | Ricardo | Last name of sampler or witnessed by | Medina |
| Title of sampler | QA Inspector | Telephone number of sampler | Not set |
| Laboratory sample identification | Not set | Linked DIME Sample ID | Not set |
| The fabricator/manufacturer/facility name | KieCon | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | PCPS Wide Flange Girder No. G-3 | Bid Item | Not set |
Material Information
| Material Type | Concrete | The concrete mix design number | K6090-621SCC |
|---|---|---|---|
| The truck number from where the sample was collected | Not set | The batch plant ticket number from where the sample was collected | unknown |
| Concrete batch plant | Not set | The fabricator/manufacturer designation for the sample | KieCon |
| A detailed description of where the material sample was collected | By formwork at precast plant during pour inspection (Third Truck Load) | Where the material sample would have been placed if not sampled | Not set |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Date Added | Verified? | Release Date | Test Comments | Privacy Level | Actions |
|---|---|---|---|---|---|---|---|---|---|
| No results found. | |||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||