Sample Record

Owner Lab

  • CT D01 - Crescent City Field Laboratory

DIME Sample ID 2023-04-11-8

Project Information

Project IdentifiersProject ID: 215620
DEA: 01436404
EFIS: 0100000193
DIST-CO-RTE-PM01-DN-101-35.8/36.5
Award Date07/11/2022
Closeout DateNot set
Work DescriptionDr. Fine Bridge Replacement
Location DescriptionDR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
QA Service Level1 (Verified on 03/26/2021)

Sample Information

Sample Taken Date04/11/2023 Sample Unique Key8
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 testing04/12/2023
Sample typeVerification A brief description of the sample4000 psi concrete
The quantity of what the sample constitutes300 CYS From where was the sample collectedJob Site
First name of sampler or witnessed byTance Last name of sampler or witnessed bySingletary
Title of samplerASR Telephone number of sampler4074628500
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTidewater Starry pit Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier01-0041 temporary bridge
Structure nameSmith River bridge

Material Information

Material TypeConcrete The concrete mix design numberSR-Min ST NA
The truck number from where the sample was collected111 The batch plant ticket number from where the sample was collected58167
Concrete batch plantTidewater Starry The fabricator/manufacturer designation for the samplebatch
A detailed description of where the material sample was collectedBack of Truck Where the material sample would have been placed if not sampledAbutment 1 LT
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-04-11-8-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJoshua Erler, CT D01 - Crescent City Field Laboratory 05/09/2023Joshua Erler
No
28 day break Info

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-04-11-8-1 CTM 521-June 2020