Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2021-01-27-6

Project Information

Project IdentifiersProject ID: 213746
DEA: 080Q75U4
EFIS: 0817000114
DIST-CO-RTE-PM08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2
Award DateNot set
Closeout DateNot set
Work DescriptionREPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS
Location DescriptionNot set
QA Service Level1 (Verified on 06/17/2019)

Sample Information

Sample Taken Date01/27/2021 Sample Unique Key6
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 testing02/03/2021
Sample typeQuality Assurance A brief description of the sampleCONCRETE CYLINDERS
The quantity of what the sample constitutes6 Cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byNA Last name of sampler or witnessed byNA
Title of samplerRMA Telephone number of sampler
Laboratory sample identification999-127 Linked DIME Sample ID
The fabricator/manufacturer/facility nameShort Load Concrete Inc Transportation Laboratory (TL) Number999-127
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberna LCBRS
The truck number from where the sample was collectedNA The batch plant ticket number from where the sample was collectedNA
Concrete batch plantVOLUMETRIC TRUCK The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSITE Where the material sample would have been placed if not sampledNA
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.