Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-04-05-40
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Project Information
| Project Identifiers | Project ID: 213406 DEA: 030F2504 EFIS: 0300000075 |
|---|---|
| DIST-CO-RTE-PM | 03-YOL,SAC-80-R11.1/R11.7,M0.0/M0.5 |
| Award Date | 08/21/2020 |
| Closeout Date | 07/31/2023 |
| Work Description | SAC RIVER BOH (BRYTE BEND) |
| Location Description | SACRAMENTO AND YOLO COUNTIES IN WEST SACRAMENTO AND SACRAMENTO FROM 0.1 MILE WEST OF REED AVENUE UNDERCROSSING TO 0.1 MILE EAST OF SACRAMENTO RIVER BRIDGE AND OVERHEAD |
| QA Service Level | 1 (Verified on 06/07/2018) |
Sample Information
| Sample Taken Date | 04/05/2021 | Sample Unique Key | 40 |
|---|---|---|---|
| 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 | 04/05/2021 |
| Sample type | Authorization | A brief description of the sample | rapid set patching |
| The quantity of what the sample constitutes | 2 Bags | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Michael | Last name of sampler or witnessed by | Mullins |
| Title of sampler | MREA | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CTS Cement | Transportation Laboratory (TL) Number | C019 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Rapid Set | Manufacturer | CTS Cement |
|---|---|---|---|
| Mix no. | 3505 | Materials Received | CTS Rapid Set DOT Repair Mix |
| Lot no. | 23111159 | Batch no. | 23111159 |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-04-05-40-1 CONCLP 2-16 (Verified)