Sample Record

Owner Labs

  • CT HQ - Sacramento Structural Materials Testing Laboratory
  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2022-04-27-32

Project Information

Project IdentifiersProject ID: 210673
DEA: 042640F4
EFIS: 0400020132
COOP: 042308A3
DIST-CO-RTE-PM04---
Award DateNot set
Closeout DateNot set
Work DescriptionNot set
Location DescriptionNot set
QA Service Level1 (Verified on 04/11/2022)

Sample Information

Sample Taken Date04/27/2022 Sample Unique Key32
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 testing05/13/2022
Sample typeQuality Assurance A brief description of the sample2 6x12 concrete cylinders
The quantity of what the sample constitutes131 CY Structural Concrete Approach Slab From where was the sample collectedJob Site
First name of sampler or witnessed byPhilip Last name of sampler or witnessed byLatasa
Title of samplerTEC Telephone number of sampler17072460441
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier20-0301
Structure nameRAUC St3 Approach Slabs

Material Information

Material TypeConcrete The concrete mix design number4201A
The truck number from where the sample was collected1454 The batch plant ticket number from where the sample was collected423416
Concrete batch plant138 The fabricator/manufacturer designation for the sampleShamrock Materials
A detailed description of where the material sample was collectedCHUTE OF TRUCK Where the material sample would have been placed if not sampledRAUC St 3 Approach Slabs Abut 1 and 3
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.