Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2022-10-27-21
Project Information
Project Identifiers | Project ID: 214336 DEA: 07302404 EFIS: 0713000488 |
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DIST-CO-RTE-PM | 07-VEN-101-37/40 |
Award Date | 11/17/2020 |
Closeout Date | 09/24/2024 |
Work Description | PADRE JUAN REHAB |
Location Description | VEN 101 |
QA Service Level | 1 (Verified on 02/26/2021) |
Sample Information
Sample Taken Date | 10/27/2022 | Sample Unique Key | 21 |
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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 | 10/27/2022 |
Sample type | Department Acceptance | A brief description of the sample | 3/8" X #8 |
The quantity of what the sample constitutes | 1,970 CY | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Kevin | Last name of sampler or witnessed by | Hopkins |
Title of sampler | Plant Inspector | Telephone number of sampler | |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Granite Ventura - Portable PCC | Transportation Laboratory (TL) Number | C102722B |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0046 |
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The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
The plant number | Granite Portable Jobsite Ventura | A detailed description of where the material sample was collected | Conveyor Belt |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
The concrete mix design number | G3-21-PCC-249R | Lot number | |
Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2022-10-27-21-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-10-27-21-2 CTM 227-December 2014 (Verified)