Sample Record
Owner Lab
- Jensen Precast - Fontana
DIME Sample ID 2021-05-04-17
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212056 DEA: 033H7204 EFIS: 0318000054 |
|---|---|
| DIST-CO-RTE-PM | 03-BUT-80-R9.2/R9.6 |
| Award Date | Not set |
| Closeout Date | 08/24/2022 |
| Work Description | remove mudslide -Construct TWLTL/turn pockets, widen shoulders, provide improved access for bicyclists/pedestrians, establish a clear recovery zone of 20 feet, and rehabilitate Class II pavement |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 04/26/2018) |
Sample Information
| Sample Taken Date | 05/04/2021 | Sample Unique Key | 17 |
|---|---|---|---|
| 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 | 05/05/2021 |
| Sample type | Quality Control | A brief description of the sample | 6"x12" Concrete Samples |
| The quantity of what the sample constitutes | 4 cylinders | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Ray / Shane | Last name of sampler or witnessed by | Brock |
| Title of sampler | QC Technician | Telephone number of sampler | 19094294133 |
| Laboratory sample identification | CB1813010007 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Jensen Precast | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 03-20000087 04 Butte | |
| Structure name | Hwy 70 Cox Lane |
Material Information
| Material Type | Concrete | The concrete mix design number | 10 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 44135 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | Plant | |
| A detailed description of where the material sample was collected | conveyor belt | Where the material sample would have been placed if not sampled | Form |
| 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: 2021-05-04-17-1 ASTM C39-18 (Verified)