Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2022-11-01-12

Project Information

Project IdentifiersProject ID: 333101
DEA: 03TEST04
EFIS: 03TEST3101
DIST-CO-RTE-PM03---
Award Date10/01/2021
Closeout DateNot set
Work DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level1 (Verified on 09/29/2021)

Sample Information

Sample Taken Date11/01/2022 Sample Unique Key12
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the sampleWB Deck Pour
The quantity of what the sample constitutes90 Cy From where was the sample collectedSource
First name of sampler or witnessed byAaron Last name of sampler or witnessed byFranklin
Title of sampler Telephone number of sampler8586990513
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameFolsom Ready Mix Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numberMix Design Test
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedtbd
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBack of Truck 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
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments