Sample Record

Owner Labs

  • CT SC Sub-unit 3674-102
  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2015-05-15-1

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/01/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date05/15/2015 Sample Unique Key1
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 testing05/20/2015
Sample typeQuality Assurance A brief description of the sample2 6x12 concrete cylinders
The quantity of what the sample constitutes18 CY RW 168 Wall From where was the sample collectedJob Site
First name of sampler or witnessed byPhilip Last name of sampler or witnessed byLatasa
Title of samplerTEC Telephone number of sampler510) 385-7179
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameShamrock Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierRW 168 Wall
Structure nameRW 168

Material Information

Material TypeConcrete The concrete mix design number4100A
The truck number from where the sample was collected1291 The batch plant ticket number from where the sample was collected426224
Concrete batch plant04 The fabricator/manufacturer designation for the sampleShamrock
A detailed description of where the material sample was collectedRW 168 Wall st 6813 to 6865 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 NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-05-15-1-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensMullinsCT HQ - Sacramento Concrete Testing Laboratory06/12/2015Mike Mullins
Yes
06/12/2015