Sample Record
Owner Lab
- CT D02 - Yreka Field Laboratory
DIME Sample ID 2023-04-20-49
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212498 DEA: 021H5204 EFIS: 0217000009 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-3,263-48.5/49.7 - 49.41 |
| Award Date | 06/09/2023 |
| Closeout Date | Not set |
| Work Description | Roadway Rehabilitation |
| Location Description | 02-Sis-3, 263-R46.8/R48.0, 49.07/49.41 |
| QA Service Level | 1 (Verified on 06/06/2017) |
Sample Information
| Sample Taken Date | 04/20/2023 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 | 04/20/2023 |
| Sample type | Acceptance | A brief description of the sample | MINOR CONC SW |
| The quantity of what the sample constitutes | 60 cy | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Danny | Last name of sampler or witnessed by | hansen |
| Title of sampler | Materials Tester | Telephone number of sampler | |
| Laboratory sample identification | 001 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Mountain Ready Mix | Transportation Laboratory (TL) Number | 166674 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 505s |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | xxx | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Back of Truck | Where the material sample would have been placed if not sampled | sta 240 to 300 |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||