Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2021-11-09-42

Project Information

Project IdentifiersProject ID: 214993
DEA: 051F5004
EFIS: 0514000003
DIST-CO-RTE-PM05-SB-101,135-70.6/71.2;0.1
Award Date11/17/2020
Closeout Date01/11/2024
Work DescriptionCONSTRUCT CONCRETE BRIDGE, BRIDGE REMOVAL, COLD PLANE, PLACE HMA.
Location DescriptionSANTA BARBARA COUNTY AT LOS ALAMOS ON ROUTE 101 FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF ROUTE 101/135 SEPARATION AND ON ROUTE 135 AT ROUTE 101/135 SEPARATION
QA Service Level1 (Verified on 09/03/2020)

Sample Information

Sample Taken Date11/09/2021 Sample Unique Key42
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 testing11/10/2021
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 - 6x12 cylinders From where was the sample collectedFabricator
First name of sampler or witnessed byAndre Last name of sampler or witnessed byTotari
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKie-Con Antioch Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number00000
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected00000
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBatch Truck Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-09-42-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensAndre Totari, CT HQ - QASI Bay Area Field Office12/07/2021Andre Totari
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2021-11-09-42-1 ASTM C39-10