Sample Record

Owner Lab

  • Kie-Con, Inc. - Antioch

DIME Sample ID 2022-02-14-34

Project Information

Project IdentifiersProject ID: 214579
DEA: 010B0904
EFIS: 0100020444
DIST-CO-RTE-PM01-DN-101-8.2/8.7
Award Date04/21/2020
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionDEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE
QA Service Level1 (Verified on 03/02/2020)

Sample Information

Sample Taken Date02/14/2022 Sample Unique Key34
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 testing02/14/2022
Sample typeQuality Control A brief description of the sample4x8 concrete 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 numberK4200CP1A
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected113558
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedSkyway 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
2022-02-14-34-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJason AllenKie-Con, Inc. - Antioch02/15/2022Gregory Lask
Yes
02/25/2022
2022-02-14-34-2CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersDavid Stasi Kie-Con, Inc. - Antioch02/21/2022Gregory Lask
Yes
02/25/2022