Sample Record

Owner Lab

  • CT SC - 3667 - Redwood Valley

DIME Sample ID 2023-05-04-16

Project Information

Project IdentifiersProject ID: 993279
DEA: 010E0904
EFIS: 0113000123
DIST-CO-RTE-PM01-MEN-20-33.3/34.4
Award Date05/06/2022
Closeout DateNot set
Work DescriptionCONSTRUCT NEW BRIDGE, REMOVE TWO BRIDGES, EARTHWORK AND PAVING. (Bridge No. 10-0310)
Location DescriptionMENDOCINO COUNTY NEAR UKIAH FROM 0.3 MILE WEST OF RUSSIAN RIVER BRIDGE AND OVERHEAD TO 0.3 MILE EAST OF COUNTY ROAD 144
QA Service Level1 (Verified on 10/04/2021)

Sample Information

Sample Taken Date05/04/2023 Sample Unique Key16
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 testing05/05/2023
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutes930 cy From where was the sample collectedJob Site
First name of sampler or witnessed byRiley Last name of sampler or witnessed byMelvin
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameNor-Cal Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier10-0310
Structure nameRussian River BOH

Material Information

Material TypeConcrete The concrete mix design number718034A
The truck number from where the sample was collectedLoad 12 The batch plant ticket number from where the sample was collected43948
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedBack of Truck 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
No results found.

Sample File Attachments

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Test File Attachments