Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2015-02-18-3

Project Information

Project IdentifiersProject ID: 209135
DEA: 04235844
EFIS: 0400000684
COOP: 042493
DIST-CO-RTE-PM04-SM-101-16.3/17.06
Award Date06/25/2014
Closeout Date12/17/2019
Work DescriptionRECONSTRUCT OVERCROSSING, RETAINING WALLS, GROUND IMPROVEMENT,
Location DescriptionBURLINGAME
QA Service Level1 (Verified on 10/03/2013)

Sample Information

Sample Taken Date02/18/2015 Sample Unique Key3
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 testing03/02/2015
Sample typeInformational A brief description of the sample6X12 cylinders
The quantity of what the sample constitutes2 From where was the sample collectedFabricator
First name of sampler or witnessed byJames Last name of sampler or witnessed byDoe
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility namekiecon Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberK6080605
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collected00000
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedFabricator 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