Sample Record
Owner Lab
- Sequoia Consultants
DIME Sample ID 2021-01-26-13
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Project Information
| Project Identifiers | Project ID: 215129 DEA: 050N73U4 EFIS: 0520000166 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101-7.3/9.6 |
| Award Date | 10/23/2020 |
| Closeout Date | Not set |
| Work Description | !!Please CC Office Engineer Gabrielle Herrera on reports to RE and SR!! Segment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar, |
| Location Description | SUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE |
| QA Service Level | 1 (Verified on 08/24/2020) |
Sample Information
| Sample Taken Date | 01/26/2021 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 01/27/2021 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 100 cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Scott | Last name of sampler or witnessed by | Powell |
| Title of sampler | QC Technician | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Hanson Goleta | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Retaining Wall 105 Footing |
Material Information
| Material Type | Concrete | The concrete mix design number | 63511N0P |
|---|---|---|---|
| The truck number from where the sample was collected | 3819 | The batch plant ticket number from where the sample was collected | 546153 |
| Concrete batch plant | Hanson Goleta | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | truck chute | 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: 2021-01-26-13-1 CTM 521-June 2020 (Verified)