Sample Record
Owner Lab
- Structure Cast
DIME Sample ID 2021-04-08-20
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214938 DEA: 120M9904 EFIS: 1213000086 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-1-9.4 |
| Award Date | 06/11/2020 |
| Closeout Date | 09/29/2021 |
| Work Description | Replace Precast RCB Culvert & Sewer Pipe & Place HMA Pavement |
| Location Description | ORANGE COUNTY IN LAGUNA BEACH AT BROADWAY STREET |
| QA Service Level | 1 (Verified on 07/17/2020) |
Sample Information
| Sample Taken Date | 04/08/2021 | Sample Unique Key | 20 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | Not set |
| Sample type | Informational | A brief description of the sample | SCC Concrete |
| The quantity of what the sample constitutes | 9.5 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Brian | Last name of sampler or witnessed by | Foley |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | StructureCast | 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 | 12-0M9904 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 3209 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Wheelbarrow | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||