Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2021-04-29-15
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Project Information
| Project Identifiers | Project ID: 214993 DEA: 051F5004 EFIS: 0514000003 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101,135-70.6/71.2;0.1 |
| Award Date | 11/17/2020 |
| Closeout Date | 01/11/2024 |
| Work Description | CONSTRUCT CONCRETE BRIDGE, BRIDGE REMOVAL, COLD PLANE, PLACE HMA. |
| Location Description | SANTA BARBARA COUNTY AT LOS ALAMOS ON ROUTE 101 FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF ROUTE 101/135 SEPARATION AND ON ROUTE 135 AT ROUTE 101/135 SEPARATION |
| QA Service Level | 1 (Verified on 09/03/2020) |
Sample Information
| Sample Taken Date | 04/29/2021 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 | 04/30/2021 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 59 CY | 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 | K7010-705 CP Orca |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 110090 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | 20-138 4/29/21 | |
| 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 | Box Girder |
| 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: 2021-04-29-15-1 ASTM C39-18 (Verified)