Sample Record
Owner Lab
- Sequoia Consultants
DIME Sample ID 2022-04-29-40
Project Information
Project Identifiers | Project ID: 215129 DEA: 050N73U4 EFIS: 0520000166 |
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DIST-CO-RTE-PM | 05-SB-101-7.3/9.6 |
Award Date | 10/22/2020 |
Closeout Date | 12/11/2023 |
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 Description | SUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE |
QA Service Level | 1 (Verified on 08/24/2020) |
Sample Information
Sample Taken Date | 04/29/2022 | Sample Unique Key | 40 |
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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 testing | 04/30/2022 |
Sample type | Quality Control | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | 1 per 100 cy | From where was the sample collected | Source |
First name of sampler or witnessed by | Jerry | Last name of sampler or witnessed by | Amato |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Hanson Goleta | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name | RW 106 |
Material Information
Material Type | Concrete | The concrete mix design number | 63511N0P |
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The truck number from where the sample was collected | 11 | The batch plant ticket number from where the sample was collected | 100737 |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | CHUTE FROM TRUCK | Where the material sample would have been placed if not sampled | |
From Lot No. | Bag Lot No. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2022-04-29-40-1 CTM 521-June 2020 (Verified)