Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-06-17-2

Project Information

Project IdentifiersProject ID: 208862
DEA: 080K7104
EFIS: 0800000366
DIST-CO-RTE-PM08-SBD-15,215-14.0/R16.4,16.0/17.8
Award Date11/13/2012
Closeout Date02/13/2017
Work DescriptionI-15/I-215 Interchange Improvements (Devore)
Location DescriptionOn I-15 from 0.8 mile south of Glen Helen Parkway UC to 1.4 mile north of Kenwood Ave UC And On I-215 from 1.2 mile south of Devore Road OC to the I-15 junction
QA Service Level1 (Verified on 06/10/2013)

Sample Information

Sample Taken Date06/17/2015 Sample Unique Key2
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 testing06/18/2015
Sample typeQuality Control A brief description of the sample6X12
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byDARREN Last name of sampler or witnessed byHOPPER
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification868-01 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJOB Transportation Laboratory (TL) Number180601
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierBRIDGES 4 AND 5
Structure nameBENT CAPS

Material Information

Material TypeConcrete The concrete mix design numberCM5800
The truck number from where the sample was collected360 The batch plant ticket number from where the sample was collected103036098
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedCHUTE Where the material sample would have been placed if not sampledUnknown
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-06-17-2-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory07/29/2015Matthew Clayton
Yes
08/12/2015