Sample Record

Owner Lab

  • CT SC - 3676 - 106

DIME Sample ID 2021-02-09-37

Project Information

Project IdentifiersProject ID: 212244
DEA: 044G8404
EFIS: 0413000051
DIST-CO-RTE-PM04-NAP-128-20.1/20.4
Award Date02/19/2019
Closeout Date06/27/2023
Work DescriptionREPLACE CAPELL CREEK BRIDGE
Location DescriptionNAPA COUNTY ABOUT 15 MILES EAST OF RUTHERFORD FROM 1.1 MILES EAST OF KNOXVILLE ROAD TO 0.3 MILE WEST OF CAPELL VALLEY CREST
QA Service Level1 (Verified on 05/20/2017)

Sample Information

Sample Taken Date02/09/2021 Sample Unique Key37
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 testing03/05/2021
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes6 Cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byNANA Last name of sampler or witnessed byBudu
Title of samplerUnknown Telephone number of sampler510-867-4517
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameHarold Smith and Sons Transportation Laboratory (TL) Number28 - Napa
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier21-0115
Structure namePier Cap Side Portion Diaphragms and Intermediate Diaphragm

Material Information

Material TypeConcrete The concrete mix design numberCT2
The truck number from where the sample was collected1127 The batch plant ticket number from where the sample was collected166218
Concrete batch plantHarold Smith and Sons The fabricator/manufacturer designation for the sampleHarold Smith
A detailed description of where the material sample was collectedBack of truck discharge chute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments