Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2022-12-06-28
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Project Information
| Project Identifiers | Project ID: 214579 DEA: 010B0904 EFIS: 0100020444 |
|---|---|
| DIST-CO-RTE-PM | 01-DN-101-8.2/8.7 |
| Award Date | 04/21/2020 |
| Closeout Date | Not set |
| Work Description | Panther Creek & Hunter Creek Bridges |
| Location Description | DEL NORTE COUNTY NEAR KLAMATH AT PANTHER CREEK BRIDGE AND AT HUNTER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 03/02/2020) |
Sample Information
| Sample Taken Date | 12/06/2022 | Sample Unique Key | 28 |
|---|---|---|---|
| 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 | 12/09/2022 |
| Sample type | Quality Assurance | A brief description of the sample | PCC cylinders |
| The quantity of what the sample constitutes | Unknown | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Omar | Last name of sampler or witnessed by | Ohmed |
| Title of sampler | TE | Telephone number of sampler | |
| Laboratory sample identification | C0147 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Unknown | Transportation Laboratory (TL) Number | 281104 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | Unknown |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 57423 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Chute | Where the material sample would have been placed if not sampled | |
| 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: 2022-12-06-28-1 CTM 521-June 2020 (Verified)