Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-09-15-30
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Project Information
| Project Identifiers | Project ID: 215168 DEA: 101C5004 EFIS: 1016000026 |
|---|---|
| DIST-CO-RTE-PM | 10-SJ-4,5-T15.5/R16.7,25.8/26.5 |
| Award Date | 12/09/2020 |
| Closeout Date | 09/14/2023 |
| Work Description | CONSTRUCT JPCP, CRCP, AND APPROACH SLABS. |
| Location Description | SAN 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 Level | 1 (Verified on 10/19/2020) |
Sample Information
| Sample Taken Date | 09/15/2021 | Sample Unique Key | 30 |
|---|---|---|---|
| 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 | 09/16/2021 |
| Sample type | Authorization | A brief description of the sample | Rapid Set |
| The quantity of what the sample constitutes | 2 Bags | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | A | Last name of sampler or witnessed by | Jose |
| Title of sampler | ASR | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CTS Cement | Transportation Laboratory (TL) Number | C923934 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Rapid Set | Manufacturer | CTS Cement Manufacturing Corporation |
|---|---|---|---|
| Mix no. | 3558 | Materials Received | Rapid Set DOT Repair Mix |
| Lot no. | 23104091 | Batch no. | 23104091 |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-09-15-30-1 CONCLP 2-16 (Verified)