Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-09-15-29

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215168
DEA: 101C5004
EFIS: 1016000026
DIST-CO-RTE-PM10-SJ-4,5-T15.5/R16.7,25.8/26.5
Award DateNot set
Closeout DateNot set
Work DescriptionCONSTRUCT JPCP, CRCP, AND APPROACH SLABS.
Location DescriptionSAN JOAQUIN COUNTY IN STOCKTON ON ROUTE 4 FROM 0.2 MILE EAST OF FRESNO AVENUE TO EL DORADO STREET AND ON ROUTE 5 FROM TAYLOR STREET OVERHEAD TO STOCKTON CHANNEL VIADUCT
QA Service Level1 (Verified on 10/19/2020)

Sample Information

Sample Taken Date09/15/2021 Sample Unique Key29
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 testing09/16/2021
Sample typeAuthorization A brief description of the sampleRapid Set
The quantity of what the sample constitutes2 Bags From where was the sample collectedJob Site
First name of sampler or witnessed byA Last name of sampler or witnessed byJose
Title of samplerASR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMaster Builder Transportation Laboratory (TL) NumberC923933
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeRapid Set ManufacturerMaster Builder
Mix no.3557 Materials ReceivedMaster Emaco T545 DOT
Lot no.30108830011 Batch no.30108830011

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-09-15-29-1CONCLP 2-16: Rapid Set Patching MaterialsSpencer AdamsCT HQ - Sacramento Concrete Testing Laboratory09/24/2021Spencer Adams
Yes
09/24/2021