Sample Record
Owner Labs
- CT HQ - Sacramento Structural Materials Testing Laboratory
- CT SC - 3672 - Petaluma
DIME Sample ID 2022-10-12-15
Project Information
Project Identifiers | Project ID: 993333 DEA: 04264724 EFIS: 0419000068 |
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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 | 10/12/2022 | Sample Unique Key | 15 |
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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 | 10/13/2022 |
Sample type | Quality Assurance | A brief description of the sample | 3 4x8 concrete cylinder molds |
The quantity of what the sample constitutes | 28 CY STRUCTURAL CONCRETE BOX CULVERT | 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 | ASR | 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 | DS 23 27 31 72 |
Material Information
Material Type | Concrete | The concrete mix design number | SL-4201CG |
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The truck number from where the sample was collected | 1433 | The batch plant ticket number from where the sample was collected | 429031 |
Concrete batch plant | 138 | 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 23 27 31 72 |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2022-10-12-15-1 ASTM C39-17a (Verified)