Sample Record
Owner Lab
- Sequoia Consultants
DIME Sample ID 2022-01-21-38
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169 |
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DIST-CO-RTE-PM | 05-SB-101-4.4/R7.7 |
Award Date | 03/01/2021 |
Closeout Date | Not set |
Work Description | Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B. |
Location Description | 101 freeway in Summerland, CA |
QA Service Level | 1 (Verified on 05/06/2021) |
Sample Information
Sample Taken Date | 01/21/2022 | Sample Unique Key | 38 |
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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 | 01/22/2022 |
Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | 1 per 100 cy | From where was the sample collected | Source |
First name of sampler or witnessed by | Rickey | Last name of sampler or witnessed by | Guevara |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Hanson Goleta | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name | Padaro Bridge Deck |
Material Information
Material Type | Concrete | The concrete mix design number | 75F1SWZ |
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The truck number from where the sample was collected | 310 | The batch plant ticket number from where the sample was collected | 551551 |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | CHUTE FROM TRUCK | 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 |
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No results found. |
Test File Attachments
DIME Test ID: 2022-01-21-38-1 CTM 521-June 2020 (Verified)