Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-07-22-50

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 Date11/01/2022
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 Date07/22/2021 Sample Unique Key50
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 testing07/23/2021
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes100CYDS 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 identificationC072221-200 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex San Juan Capistrano Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameDS 119

Material Information

Material TypeConcrete The concrete mix design number1619144
The truck number from where the sample was collected39799 The batch plant ticket number from where the sample was collected46437474
Concrete batch plantCemex San Juan Capistrano The fabricator/manufacturer designation for the sampleMix
A detailed description of where the material sample was collecteddischarge chute from the back of truck Where the material sample would have been placed if not sampledheadwall and wingwall footing
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-07-22-50-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersRuben JimenezSequoia Consultants08/19/2021Ken Mancebo
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-07-22-50-1 CTM 521-June 2020