Sample Record
Owner Lab
- Kie-Con, Incorporated - Antioch
DIME Sample ID 2022-02-01-40
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215063 DEA: 032F5704 EFIS: 0300020615 |
|---|---|
| DIST-CO-RTE-PM | 03-PLA-80-46.3/63.5 |
| Award Date | 09/23/2020 |
| Closeout Date | 08/11/2023 |
| Work Description | Replace 4 Bridges (OC) on Highway 80 from Crystal Springs to Cisco Grove (Baxter, Drum Forebay) |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 11/16/2020) |
Sample Information
| Sample Taken Date | 02/01/2022 | 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 | 02/01/2022 |
| Sample type | Quality Control | A brief description of the sample | 4x8 cylinders |
| The quantity of what the sample constitutes | 3 | 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 | K5670-100 CPA R4 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 113419 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Wetcast 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: 2022-02-01-40-1 CTM 521-June 2020 (Verified)