Sample Record

Owner Lab

  • Kie-Con, Incorporated - Antioch

DIME Sample ID 2021-05-18-54

Project Information

Project IdentifiersProject ID: 214469
DEA: 030H08U4
EFIS: 0319000029
DIST-CO-RTE-PM03-SAC-50-L0.2/R6.1
Award Date06/30/2020
Closeout DateNot set
Work DescriptionSac 50 Design Build PLEASE NOTE THAT DESIGN BUILDER MUST PERFORM QUALITY VALIDATION TESTING IN ACCORDANCE WITH THE MATERIAL CONTROL SCHEDULE (MCS) FOR ITEMS SUCH AS STRANDS, HS BOLTS, ELASTOMERIC BEARING PADS, JOINT SEALANTS, COUPLERS & WELDED HOOPS, ETC
Location DescriptionFROM 0.1 MILE EAST OF I-5 TO 0.8 MILE EAST OF WATT AVE
QA Service Level1 (Verified on 10/23/2019)

Sample Information

Sample Taken Date05/18/2021 Sample Unique Key54
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 testing05/19/2021
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes37.5 CY From where was the sample collectedFabricator
First name of sampler or witnessed byMauril Last name of sampler or witnessed byMariano
Title of samplerQuality Control Engineer Telephone number of sampler(925) 331-7110
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKIE-CON, INC Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberCTP70-V41
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected110189
Concrete batch plant The fabricator/manufacturer designation for the sample3S 5/18/21
A detailed description of where the material sample was collectedConcrete sample from wheelbarrow Where the material sample would have been placed if not sampled14 Inch Square Pile
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments