Sample Record
Owner Lab
- CT D03 - Sacramento Sanders Structures Construction Field Office
DIME Sample ID 2015-04-21-12
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 209704 DEA: 100W1904 EFIS: 1000020456 |
|---|---|
| DIST-CO-RTE-PM | 10-SJ-99-22.9/38.8 |
| Award Date | 12/19/2014 |
| Closeout Date | 01/23/2017 |
| Work Description | PAVEMENT RESURFACING |
| Location Description | SAN JOAQUIN COUNTY IN AND NEAR LODI FROM HAMMER LANE OVERCROSSING TO SACRAMENTO COUNTY LINE |
| QA Service Level | 1 (Verified on 08/07/2014) |
Sample Information
| Sample Taken Date | 04/21/2015 | Sample Unique Key | 12 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | Not set |
| Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 6x12 concrete cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Alfredo | Last name of sampler or witnessed by | Carranza |
| Title of sampler | SR | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | On site | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 628411A |
|---|---|---|---|
| The truck number from where the sample was collected | 395 | The batch plant ticket number from where the sample was collected | 71726 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | from end of pump | 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
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||