Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-02-09-42

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215014
DEA: 101C9404
EFIS: 1016000020
DIST-CO-RTE-PM10-SJ-5-26.4/27.0
Award Date11/03/2020
Closeout DateNot set
Work DescriptionBRIDGE REHABILITATION
Location DescriptionON STATE HIGHWAY IN SAN JOAQUIN COUNTY IN STOCKTON FROM 0.3 MILE NORTH OF ROUTE 5/4 SEPARATION TO PERSHING AVENUE
QA Service Level1 (Verified on 06/03/2020)

Sample Information

Sample Taken Date02/09/2021 Sample Unique Key42
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 testing02/09/2021
Sample typeQuality Assurance A brief description of the sampleRapid Setting Concrete
The quantity of what the sample constitutes2 Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byRon Last name of sampler or witnessed byMatin
Title of samplerSR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCTS Cement Transportation Laboratory (TL) Number0001
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameEntire Bridge Deck/Ramp

Material Information

Material TypeRapid Set ManufacturerCTS Cement
Mix no.3494 Materials ReceivedRapid Set DOT Repair Mix
Lot no.61106300 Batch no.61106300

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-02-09-42-1CONCLP 2-16: Rapid Set Patching MaterialsSpencer AdamsCT HQ - Sacramento Concrete Testing Laboratory02/25/2021Spencer Adams
Yes
05/19/2021