Sample Record
Owner Lab
- CT HQ - QASI Bay Area Field Office
DIME Sample ID 2021-06-08-25
Sample Details QR Code
Scan this code to open this Sample Details view on another device.
Project Information
| Project Identifiers | Project ID: 215063 DEA: 032F5704 EFIS: 0300020615 |
|---|---|
| DIST-CO-RTE-PM | 03-PLA-80-46.3/63.5 |
| Award Date | 09/23/2020 |
| Closeout Date | 08/11/2023 |
| Work Description | Replace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay) |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/16/2020) |
Sample Information
| Sample Taken Date | 06/08/2021 | Sample Unique Key | 25 |
|---|---|---|---|
| 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 | 06/08/2021 |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 - 6x12 cylinders | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Saman | Last name of sampler or witnessed by | Barzegari |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Kie-Con Antioch | 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 | 000000000000 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 000000000000 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Kie-Con Antioch | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||