Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2022-01-12-26
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Project Information
| Project Identifiers | Project ID: 213099 DEA: 041A6614 EFIS: 0415000291 COOP: 042683A1 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-8.4 |
| Award Date | 11/30/2020 |
| Closeout Date | 12/12/2023 |
| Work Description | CONSTRUCTION ON STATE HIGHWAY IN MARIN COUNTY IN LARKSPUR |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/06/2020) |
Sample Information
| Sample Taken Date | 01/12/2022 | Sample Unique Key | 26 |
|---|---|---|---|
| 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 | 01/20/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 4x8 concrete cylinders |
| The quantity of what the sample constitutes | 3 cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Harry | Last name of sampler or witnessed by | Suryantoro |
| Title of sampler | ASR | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Kaiser | Transportation Laboratory (TL) Number | 211501 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Greenbrae Pedestrian OC |
Material Information
| Material Type | Concrete | The concrete mix design number | Unknown |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | Unknown | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Chute | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-01-12-26-1 ASTM C39-17a (Verified)