Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2023-02-15-1

Project Information

Project IdentifiersProject ID: 99999
DEA: 0322222
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level (Verified on 04/05/2013)

Sample Information

Sample Taken Date02/15/2023 Sample Unique Key1
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 testing02/15/2023
Sample typeQuality Assurance A brief description of the samplebeams
The quantity of what the sample constitutes1 From where was the sample collectedJob Site
First name of sampler or witnessed byAlexis Last name of sampler or witnessed byCorona
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCMC Rbar 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 number1234
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected123
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedwheelbarrow 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

File NameExtensionDate UploadedActions
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Test File Attachments