Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2022-01-20-11
Project Information
Project Identifiers | Project ID: 214993 DEA: 051F5004 EFIS: 0514000003 |
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DIST-CO-RTE-PM | 05-SB-101,135-70.6/71.2;0.1 |
Award Date | 11/17/2020 |
Closeout Date | 01/11/2024 |
Work Description | CONSTRUCT CONCRETE BRIDGE, BRIDGE REMOVAL, COLD PLANE, PLACE HMA. |
Location Description | SANTA 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 Level | 1 (Verified on 09/03/2020) |
Sample Information
Sample Taken Date | 01/20/2022 | Sample Unique Key | 11 |
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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 Control | A brief description of the sample | 4x8 concrete cylinders |
The quantity of what the sample constitutes | 58 CY | From where was the sample collected | Fabricator |
First name of sampler or witnessed by | Stephen | Last name of sampler or witnessed by | Haynes |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | KIE-CON, INC | 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 | K7010-705 CPO R3 |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 113331 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | 20-138 1/20/22 | |
A detailed description of where the material sample was collected | Concrete sample from wheelbarrow | Where the material sample would have been placed if not sampled | Box Girder |
From Lot No. | Bag Lot No. |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |