Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2022-02-04-28

Project Information

Project IdentifiersProject ID: 215129
DEA: 050N73U4
EFIS: 0520000166
DIST-CO-RTE-PM05-SB-101-7.3/9.6
Award Date10/23/2020
Closeout DateNot set
Work Description!!Please CC Office Engineer Gabrielle Herrera on reports to RE and SR!! Segment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar,
Location DescriptionSUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE
QA Service Level1 (Verified on 08/24/2020)

Sample Information

Sample Taken Date02/04/2022 Sample Unique Key28
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 testing02/05/2022
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes100 cy From where was the sample collectedSource
First name of sampler or witnessed byErroll Last name of sampler or witnessed byBenton
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHanson Goleta Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameRetaining Wall 164

Material Information

Material TypeConcrete The concrete mix design number63511N0P
The truck number from where the sample was collected552 The batch plant ticket number from where the sample was collected551715
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-02-04-28-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJulio Lugo, Sequoia Consultants03/04/2022Ruben Jimenez
Yes
03/08/2022

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2022-02-04-28-1 CTM 521-June 2020 (Verified)