Sample Record
Owner Lab
- CT D12 - Huntington Beach Field Laboratory
DIME Sample ID 2022-10-24-41
Project Information
Project Identifiers | Project ID: 993136 DEA: 120Q3904 EFIS: 1217000003 |
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DIST-CO-RTE-PM | 12-ORA-55-4.7 |
Award Date | 09/20/2021 |
Closeout Date | Not set |
Work Description | RECONSTRUCT REINFORCED STRUCTURAL CONCRETE BRIDGE AND BARRIER. |
Location Description | ORANGE COUNTY IN COSTA MESA AT ROUTE 55/73 CONNECTOR |
QA Service Level | 1 (Verified on 07/27/2021) |
Sample Information
Sample Taken Date | 10/24/2022 | Sample Unique Key | 41 |
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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 | 10/25/2022 |
Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | 6 concrete cylinders | From where was the sample collected | Job Site |
First name of sampler or witnessed by | David | Last name of sampler or witnessed by | Saretsky |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 22-0398 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Unknown | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | SC590M35 |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 1 | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | MIX TRUCK | Where the material sample would have been placed if not sampled | Barrier Pour 55 and 73 Connector |
From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
---|---|---|---|
No results found. |
Test File Attachments
DIME Test ID: 2022-10-24-41-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2022-10-24-41-2 CTM 521-June 2020 (Verified)