Sample Record

Owner Lab

  • Sequoia Consultant

DIME Sample ID 2021-08-30-53

Project Information

Project IdentifiersProject ID: 215050
DEA: 080R1424
EFIS: 0815000201
DIST-CO-RTE-PM08-SBD-40-R125.0/R154.6
Award Date08/26/2020
Closeout DateNot set
Work DescriptionROADWAY EXCAVATION, IMPORT BORROW AND REGRADE THE MEDIAN SLOPE.
Location DescriptionSAN BERNARDINO COUNTY FROM 4.5 MILES EAST OF HOMER WASH BRIDGE TO ARIZONA STATE LINE
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date08/30/2021 Sample Unique Key53
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 testing08/31/2021
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes100 cyds From where was the sample collectedJob Site
First name of sampler or witnessed byRobert Last name of sampler or witnessed byMavis
Title of samplerField Technician Telephone number of sampler
Laboratory sample identificationC083021-202 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Bullhead City Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameDS 153

Material Information

Material TypeConcrete The concrete mix design number161944
The truck number from where the sample was collected39796 The batch plant ticket number from where the sample was collected46513167
Concrete batch plantCemex Bullhead City The fabricator/manufacturer designation for the sampleMix
A detailed description of where the material sample was collectedDischarge chute from back of truck Where the material sample would have been placed if not sampledHead wall and wing wall footings
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-08-30-53-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersRuben JimenezSequoia Consultant09/27/2021Ken Mancebo
No
Info