Sample Record

Owner Labs

  • CT SC Sub-unit 3672-105
  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-06-22-27

Project Information

Project IdentifiersProject ID: 213099
DEA: 041A6614
EFIS: 0415000291
COOP: 042683A1
DIST-CO-RTE-PM04-MRN-101-8.4
Award Date11/30/2020
Closeout DateNot set
Work DescriptionCONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR
Location DescriptionNot set
QA Service Level1 (Verified on 11/06/2020)

Sample Information

Sample Taken Date06/22/2021 Sample Unique Key27
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 testing07/01/2021
Sample typeQuality Assurance A brief description of the sampleType II Cement
The quantity of what the sample constitutes3 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byHLa Last name of sampler or witnessed byKey
Title of samplerASR Telephone number of sampler510-385-6764
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameshamrock Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameCIDH F15 bent

Material Information

Material TypeConcrete The concrete mix design numberSL 4707 CG
The truck number from where the sample was collected1422 The batch plant ticket number from where the sample was collected195730
Concrete batch plantShamrock Materials The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampledCIDH Piles
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-22-27-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensSACT HQ - Sacramento Concrete Testing Laboratory07/20/2021SA
Yes
07/20/2021