Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2022-03-05-1

Project Information

Project IdentifiersProject ID: 215236
DEA: 081C6804
EFIS: 0812000343
DIST-CO-RTE-PM08-RIV-74,79and371-Varies
Award Date12/29/2020
Closeout DateNot set
Work DescriptionREPLACE STRUCTURAL CONCRETE BRIDGE, RETAINING WALL AND BOX CULVERT.
Location DescriptionRIVERSIDE COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 03/02/2021)

Sample Information

Sample Taken Date03/05/2022 Sample Unique Key1
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 testing03/05/2022
Sample typeQuality Control A brief description of the sample4000 psi 1" P/P Slag
The quantity of what the sample constitutes2 Cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byZacarias Last name of sampler or witnessed byFlores
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Perris 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 number1610974
The truck number from where the sample was collected70480 The batch plant ticket number from where the sample was collected30118848
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedLocation 3 Stage 2 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
2022-03-05-1-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersZacarias FloresSequoia Consultants04/04/2022Alexandria Oser
Yes
04/04/2022