Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2021-04-12-21
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Project Information
| Project Identifiers | Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 |
|---|---|
| DIST-CO-RTE-PM | 01-DN-101-8.2/8.7 |
| Award Date | 04/21/2020 |
| Closeout Date | Not set |
| Work Description | Panther Creek & Hunter Creek Bridges |
| Location Description | DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 03/02/2020) |
Sample Information
| Sample Taken Date | 04/12/2021 | Sample Unique Key | 21 |
|---|---|---|---|
| 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 | 04/13/2021 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 16.5 YDS | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Stephen | Last name of sampler or witnessed by | Haynes |
| Title of sampler | QC Inspector Technician | Telephone number of sampler | 9253317125 |
| 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 |
Material Information
| Material Type | Concrete | The concrete mix design number | K4200 CP1A |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 109958 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | 20-020C 4/12/21 | |
| A detailed description of where the material sample was collected | Concrete sample from wheelbarrow | Where the material sample would have been placed if not sampled | Diaphragm |
| 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: 2021-04-12-21-1 ASTM C39-18 (Verified)
DIME Test ID: 2021-04-12-21-2 ASTM C39-18 (Verified)