Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2021-10-16-6

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 213653
DEA: 044G8204
EFIS: 0413000049
DIST-CO-RTE-PM04-MRN-101-10.6/10.8
Award Date05/05/2020
Closeout DateNot set
Work DescriptionREPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location DescriptionMARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date10/16/2021 Sample Unique Key6
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 testing10/25/2021
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes3 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byHarry Last name of sampler or witnessed bySuryantoro
Title of samplerASR Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCEMEX Victorville Transportation Laboratory (TL) Number222514
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameSan Rafael Harbor

Material Information

Material TypeConcrete The concrete mix design number3372CE
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedUnknown
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedChute Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-10-16-6-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensSACT HQ - Sacramento Concrete Testing Laboratory11/15/2021SA
Yes
11/15/2021