Sample Record

Owner Labs

  • CT HQ - Sacramento Structural Materials Testing Laboratory
  • CT SC - 3672 - Petaluma

DIME Sample ID 2022-10-07-24

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
QA Service Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date10/07/2022 Sample Unique Key24
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 testing10/07/2022
Sample typeQuality Assurance A brief description of the sample3 4x8 concrete cylinder molds
The quantity of what the sample constitutes36 CY for DS 72 23 34 34 Invert walls roof From where was the sample collectedJob Site
First name of sampler or witnessed byJeremy Last name of sampler or witnessed byLight
Title of samplerTEC Telephone number of sampler15103939273
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Petaluma Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameDrainage systems inverts wall roofs

Material Information

Material TypeConcrete The concrete mix design numberSL-4201CG
The truck number from where the sample was collected1415 The batch plant ticket number from where the sample was collected105854
Concrete batch plant142 The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampledDS 72 23 27 31 34
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-10-07-24-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensPM, CT HQ - Sacramento Concrete Testing Laboratory11/04/2022PM
Yes
11/04/2022

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2022-10-07-24-1 ASTM C39-17a (Verified)