Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-10-20-40

Project Information

Project IdentifiersProject ID: 215236
DEA: 081C6804
EFIS: 0812000343
DIST-CO-RTE-PM08-RIV-74,79and371-Varies
Award Date12/29/2020
Closeout DateNot set
Work DescriptionREPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT.
Location DescriptionRIVERSIDE COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/02/2021)

Sample Information

Sample Taken Date10/20/2021 Sample Unique Key40
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 testing10/21/2021
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 byDerek Last name of sampler or witnessed byBezotte
Title of samplerField Technician Telephone number of sampler
Laboratory sample identificationC102021-200 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Perris Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameLeach Canyon Channel Bridge

Material Information

Material TypeConcrete The concrete mix design number1614705
The truck number from where the sample was collected10064190 The batch plant ticket number from where the sample was collected29917196
Concrete batch plantCemex Perris 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 sampledAbutment 1 and 2 CIDH piles
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-10-20-40-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersRuben Jimenez, Sequoia Consultants11/17/2021Ken Mancebo
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-10-20-40-1 CTM 521-June 2020