Sample Record

Owner Lab

  • CT D03 - Sacramento Sanders Structures Construction Field Office

DIME Sample ID 2015-02-03-1

Project Information

Project IdentifiersProject ID: 209059
DEA: 033E1004
EFIS: 0300000473
DIST-CO-RTE-PM03-PLA-80-8.1/37.8
Award Date01/28/2014
Closeout Date01/23/2017
Work DescriptionIMPROVING VERTICAL CLEARANCE
Location DescriptionPLACER COUNTY IN AND NEAR LOOMIS, PENRYN, NEWCASTLE, WEIMAR, AND MAGRA FROM 0.1 MILE WEST OF BRACE ROAD OVERCROSSING TO 0.1 MILE EAST OF MAGRA OVERCROSSING
QA Service Level1 (Verified on 01/15/2014)

Sample Information

Sample Taken Date02/03/2015 Sample Unique Key1
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the sample2 6x12 concrete cylinders
The quantity of what the sample constitutes2 6x12 concrete cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byBrandon Last name of sampler or witnessed byMiller
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert 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 numberJ7A8543CC
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected2
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedTruck Where the material sample would have been placed if not sampledNot set
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments