Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-06-18-4

Project Information

Project IdentifiersProject ID: 209453
DEA: 080J8504
EFIS: 0800000324
DIST-CO-RTE-PM08-SBD-138-R24.1
Award Date07/01/2014
Closeout Date07/05/2017
Work DescriptionREPLACE EXISTING BRIDGE.
Location DescriptionSAN BERNARDINO COUNTY IN AND NEAR HESPERIA AT HORSETHIEF CREEK BRDIGE
QA Service Level1 (Verified on 04/16/2014)

Sample Information

Sample Taken Date06/18/2015 Sample Unique Key4
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 testing06/23/2015
Sample typeQuality Control A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byG Last name of sampler or witnessed byPAREDES
Title of samplerASR Telephone number of samplerUnknown
Laboratory sample identification901-18B Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCollected at jobsite Transportation Laboratory (TL) Number150618B
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierUnknown
Structure nameUnknown

Material Information

Material TypeConcrete The concrete mix design numberSITI72A
The truck number from where the sample was collectedUnknown The batch plant ticket number from where the sample was collectedNOT PROVIDED
Concrete batch plantUnknown The fabricator/manufacturer designation for the sampleUnknown
A detailed description of where the material sample was collectedBRIDGE DECK SPAN 2 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
2015-06-18-4-1CTM 521-November 2014: Method of Test for Compressive Strength of Molded Concrete CylindersMatthew ClaytonCT - Southern Regional Laboratory07/01/2015Matthew Clayton
Yes
07/03/2015