Sample Record
Owner Lab
- CT SC - 3674 - Pacifica 2
DIME Sample ID 2015-04-10-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 7463 DEA: 042640U4 EFIS: 0412000195 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-101-0.9/3.6 |
| Award Date | 11/02/2012 |
| Closeout Date | 06/03/2020 |
| Work Description | CONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR |
| Location Description | SONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD |
| QA Service Level | 1 (Verified on 09/11/2012) |
Sample Information
| Sample Taken Date | 04/10/2015 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 04/24/2015 |
| Sample type | Quality Assurance | A brief description of the sample | 4 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 9 CY concret used in girder spleces | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Harry | Last name of sampler or witnessed by | Suryantaro |
| Title of sampler | TEC | Telephone number of sampler | 510) 385-7179 |
| Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | Unknown |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | 200295 |
| Structure name | Petaluma River Bridge |
Material Information
| Material Type | Concrete | The concrete mix design number | 4700P |
|---|---|---|---|
| The truck number from where the sample was collected | 1214 | The batch plant ticket number from where the sample was collected | 425247 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Shamrock |
| A detailed description of where the material sample was collected | Concrete used in girder closure pours pier 5 N S Stage 3 east | Where the material sample would have been placed if not sampled | Not set |
| From Lot No. | Not set | Bag Lot No. | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2015-04-10-2-1 ASTM C39-10 (Verified)
DIME Test ID: 2015-04-10-2-2 ASTM C39-10 (Verified)