Sample Record

Owner Lab

  • CT D07 - Materials Field Laboratory, Unit 1953

DIME Sample ID 2022-10-04-43

Project Information

Project IdentifiersProject ID: 214336
DEA: 07302404
EFIS: 0713000488
Award DateNot set
Closeout DateNot set
Work DescriptionPADRE JUAN REHAB
Location DescriptionVEN 101
QA Service Level1 (Verified on 02/26/2021)

Sample Information

Sample Taken Date10/04/2022 Sample Unique Key43
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 testing10/05/2022
Sample typeDepartment Acceptance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes130 CY From where was the sample collectedManufacturer
First name of sampler or witnessed byDerek Last name of sampler or witnessed byBezotte
Title of samplerSequoia QC Telephone number of sampler
Laboratory sample identification22-2649 Linked DIME Sample ID
The fabricator/manufacturer/facility nameGranite Construction Batch Plant Transportation Laboratory (TL) Number22-2649
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberG3-21-PCC-249R
The truck number from where the sample was collected6 The batch plant ticket number from where the sample was collected9005
Concrete batch plantGranite Construction Ventura The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedFrom loader to wheelbarrow Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments