Sample Record
Owner Lab
- Pro-Cast Products, Inc. - Highland
DIME Sample ID 2021-10-07-118
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 215333 DEA: 120S6604 EFIS: 1221000004 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-91-R16.6/R17.0 |
| Award Date | 05/18/2021 |
| Closeout Date | Not set |
| Work Description | COLD PLANE AC PAVEMENT AND PLACE PRECAST CONCRETE PAVEMENT. |
| Location Description | ORANGE COUNTY IN YORBA LINDA FROM W91-S241/91 CONNECTOR SEPARATION TO 0.6 MILE EAST OF GYPSUM CANYON ROAD UNDERCROSSING |
| QA Service Level | 1 (Verified on 02/22/2021) |
Sample Information
| Sample Taken Date | 10/07/2021 | Sample Unique Key | 118 |
|---|---|---|---|
| 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 | 10/08/2021 |
| Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 8 | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Robert | Last name of sampler or witnessed by | Lopez |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | ProCast Products | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | RRM14062 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | TT | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete from wheelbarrow | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |