Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2021-11-29-32
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215075 DEA: 060Q9104 EFIS: 0614000005 |
|---|---|
| DIST-CO-RTE-PM | 06-TUL-99-19.2/19.8 |
| Award Date | 09/25/2020 |
| Closeout Date | 05/11/2023 |
| Work Description | BRIDGE DECK AND OUTSIDE GIRDER REPLACEMENT. |
| Location Description | TULARE COUNTY NEAR TIPTON FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF AVENUE 152 OVERCROSSING |
| QA Service Level | 1 (Verified on 07/28/2020) |
Sample Information
| Sample Taken Date | 11/29/2021 | Sample Unique Key | 32 |
|---|---|---|---|
| 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 testing | 11/29/2021 |
| Sample type | Quality Assurance | A brief description of the sample | Grout |
| The quantity of what the sample constitutes | 1 Bag | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Peter | Last name of sampler or witnessed by | Moua |
| Title of sampler | Structure Rep | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Sika Corporation | Transportation Laboratory (TL) Number | G-1 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Rapid Set | Manufacturer | Sika Corporation |
|---|---|---|---|
| Mix no. | 3589 | Materials Received | SikaGrout 212 |
| Lot no. | 2721 1109620 B-42 | Batch no. | 2721 1109620 B-42 |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||