Sample Record

Owner Lab

  • Kie-Con, Incorporated - Antioch

DIME Sample ID 2022-02-01-40

Project Information

Project IdentifiersProject ID: 215063
DEA: 032F5704
EFIS: 0300020615
DIST-CO-RTE-PM03-PLA-80-46.3/63.5
Award Date11/02/2020
Closeout DateNot set
Work DescriptionReplace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay)
Location DescriptionNot set
QA Service Level1 (Verified on 11/16/2020)

Sample Information

Sample Taken Date02/01/2022 Sample Unique Key40
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 testing02/01/2022
Sample typeQuality Control A brief description of the sample4x8 cylinders
The quantity of what the sample constitutes3 From where was the sample collectedManufacturer
First name of sampler or witnessed byGreg Last name of sampler or witnessed byLask
Title of samplerQCM Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKIECON 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 numberK5670-100 CPA R4
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected113419
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedWetcast bed 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
2022-02-01-40-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJason AllenKie-Con, Incorporated - Antioch02/02/2022Gregory Lask
Yes
02/25/2022

Sample File Attachments

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Test File Attachments


DIME Test ID: 2022-02-01-40-1 CTM 521-June 2020 (Verified)