Sample Record
Owner Lab
- Con-Fab California Corporation - Lathrop
DIME Sample ID 2021-06-11-37
Project Information
Project Identifiers | Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 |
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DIST-CO-RTE-PM | 02-SIS-3-38.0/38.6 |
Award Date | 04/05/2021 |
Closeout Date | 08/14/2023 |
Work Description | BRIDGE REPLACEMENT |
Location Description | SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD |
QA Service Level | 1 (Verified on 01/19/2021) |
Sample Information
Sample Taken Date | 06/11/2021 | Sample Unique Key | 37 |
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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 | 07/09/2021 |
Sample type | Quality Control | A brief description of the sample | Concrete 6 x 12 Cylinders |
The quantity of what the sample constitutes | 2 6x12 concrete cylinders | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Mark Patrick | Last name of sampler or witnessed by | Baddu |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | ConFab California, LLC | 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 | 98LV25AF |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 3381 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | Bed 1B, 3rd Truck | 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 |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |