Sample Record
Owner Labs
- CT HQ - Sacramento Structural Materials Testing Laboratory
- CT SC - 3672 - Petaluma
DIME Sample ID 2022-10-07-24
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993333 DEA: 04264724 EFIS: 0419000068 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-R20.8/27.1 |
| Award Date | 04/26/2022 |
| Closeout Date | Not set |
| Work Description | CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL. |
| Location Description | MARIN 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 Level | 1 (Verified on 11/01/2021) |
Sample Information
| Sample Taken Date | 10/07/2022 | Sample Unique Key | 24 |
|---|---|---|---|
| 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 | 10/07/2022 |
| Sample type | Quality Assurance | A brief description of the sample | 3 4x8 concrete cylinder molds |
| The quantity of what the sample constitutes | 36 CY for DS 72 23 34 34 Invert walls roof | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jeremy | Last name of sampler or witnessed by | Light |
| Title of sampler | TEC | Telephone number of sampler | 15103939273 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Shamrock Materials Petaluma | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Drainage systems inverts wall roofs |
Material Information
| Material Type | Concrete | The concrete mix design number | SL-4201CG |
|---|---|---|---|
| The truck number from where the sample was collected | 1415 | The batch plant ticket number from where the sample was collected | 105854 |
| Concrete batch plant | 142 | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | CHUTE FROM TRUCK | Where the material sample would have been placed if not sampled | DS 72 23 27 31 34 |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-10-07-24-1 ASTM C39-17a (Verified)