Sample Record

Owner Lab

  • Con-Fab California Corporation - Lathrop

DIME Sample ID 2021-04-14-9

Project Information

Project IdentifiersProject ID: 214795
DEA: 030H3424
EFIS: 0317000153
DIST-CO-RTE-PM03-SAC-99-22.6
Award Date01/06/2021
Closeout DateNot set
Work DescriptionREPLACE BRIDGE DECK WITH PRESTRESSED CONCRETE BOX GIRDER.
Location DescriptionSACRAMENTO COUNTY IN SACRAMENTO AT 21ST AVENUE UNDERCROSSING
QA Service Level1 (Verified on 03/12/2020)

Sample Information

Sample Taken Date04/14/2021 Sample Unique Key9
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 testing04/15/2021
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 6x12 concrete cylinders From where was the sample collectedManufacturer
First name of sampler or witnessed byMark Patrick Last name of sampler or witnessed byBaddu
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCon-Fab California, LLC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberVER-95LV
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected3273
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBed 2, 2nd Truck Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

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