Sample Record
Owner Lab
- Sequoia Consultants
DIME Sample ID 2022-01-27-40
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214756 DEA: 050N7AU4 EFIS: 0520000030 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101-1.4/4.8 |
| Award Date | Not set |
| Closeout Date | 09/27/2022 |
| Work Description | Segment 4A - Carpinteria: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, epoxy coated rebar, precast box culverts, precast RCP. |
| Location Description | CARPINTERIA FROM 0.2 MILE SOUTH OF BAILARD AVENUE OVERCROSSING TO 0.7 MILE SOUTH OF SOUTH PADARO LANE |
| QA Service Level | 1 (Verified on 03/09/2020) |
Sample Information
| Sample Taken Date | 01/27/2022 | Sample Unique Key | 40 |
|---|---|---|---|
| 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 | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 100 cy | From where was the sample collected | Source |
| First name of sampler or witnessed by | Robert | Last name of sampler or witnessed by | Mavis |
| 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 | Sound Wall 1 Pile Cap |
Material Information
| Material Type | Concrete | The concrete mix design number | 63511N0P |
|---|---|---|---|
| The truck number from where the sample was collected | 552 | The batch plant ticket number from where the sample was collected | 43613 |
| 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. |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-01-27-40-1 CTM 521-June 2020 (Verified)