Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2021-11-09-70

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 Date11/09/2021 Sample Unique Key70
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 testing11/10/2021
Sample typeQuality Control A brief description of the samplePCC
The quantity of what the sample constitutes2 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byRandy Last name of sampler or witnessed byBlack
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 number91-36-0040
The truck number from where the sample was collected10067255 The batch plant ticket number from where the sample was collected29946320
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-09-70-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJesse Uranga, Sequoia Consultants12/07/2021Alexandria Oser
Yes
07/14/2022

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2021-11-09-70-1 CTM 521-June 2020 (Verified)