Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2022-01-27-7
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Project Information
| Project Identifiers | Project ID: 214993 DEA: 051F5004 EFIS: 0514000003 |
|---|---|
| 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 | 01/27/2022 | Sample Unique Key | 7 |
|---|---|---|---|
| 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 | 01/28/2022 |
| Sample type | Quality Control | A brief description of the sample | Concrete Test Cylinder 4x8 |
| The quantity of what the sample constitutes | 2 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Greg | Last name of sampler or witnessed by | Lask |
| Title of sampler | QCM | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | KIECON | 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 | K7010705CPOR3 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 113392 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Wilbur Bed | 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: 2022-01-27-7-1 CTM 521-June 2020 (Verified)