Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2022-01-12-57

Project Information

Project IdentifiersProject ID: 215050
DEA: 080R1424
EFIS: 0815000201
DIST-CO-RTE-PM08-SBD-40-R125.0/R154.6
Award Date08/26/2020
Closeout Date11/01/2022
Work DescriptionROADWAY EXCAVATION, IMPORT BORROW AND REGRADE THE MEDIAN SLOPE.
Location DescriptionSAN BERNARDINO COUNTY FROM 4.5 MILES EAST OF HOMER WASH BRIDGE TO ARIZONA STATE LINE
QA Service Level1 (Verified on 06/23/2021)

Sample Information

Sample Taken Date01/12/2022 Sample Unique Key57
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 testing01/12/2022
Sample typeQuality Control A brief description of the samplestructural concrete
The quantity of what the sample constitutes2 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byIsidro Last name of sampler or witnessed byBuenrostro
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Bullhead City AZ Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number1619144
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected46769862
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedS36 W Walls and DS42 RCB Deck Walls Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-01-12-57-1CTM 521-June 2012: Method of Test for Compressive Strength of Molded Concrete CylindersIsidro BuenrostroSequoia Consultants01/12/2022Alexandria Oser
No
Info

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-01-12-57-1 CTM 521-June 2012