Sample Record

Owner Lab

  • Sequoia Consultants

DIME Sample ID 2022-11-05-17

Project Information

Project IdentifiersProject ID: 215129
DEA: 050N73U4
EFIS: 0520000166
DIST-CO-RTE-PM05-SB-101-7.3/9.6
Award Date10/22/2020
Closeout Date12/11/2023
Work Description!!Please CC Office Engineer Gabrielle Herrera on reports to RE and SR!! Segment 4C - Summerland: Construct HOV lanes and rehabilitation. Source inspection of sign structure trusses, lighting structures, steel soldier piles, epoxy coated rebar,
Location DescriptionSUMMERLAND FROM 0.2 MILES NORTH OF PARDARO LANE OVERCROSSING TO SAN YSIDRO CREEK BRIDGE
QA Service Level1 (Verified on 08/24/2020)

Sample Information

Sample Taken Date11/05/2022 Sample Unique Key17
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 testing11/06/2022
Sample typeQuality Control A brief description of the sampleStructural Concrete
The quantity of what the sample constitutes2 cyliners From where was the sample collectedJob Site
First name of sampler or witnessed byTim Last name of sampler or witnessed byReyes
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMartin Marrieta Goleta 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 number63511N0P
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected3432181
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedNB 101 SW 101 moment slab at stations 13 and 20 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
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Sample File Attachments

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Test File Attachments