Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2023-05-05-30
Project Information
Project Identifiers | Project ID: 994062 DEA: 010F5104 EFIS: 0116000015 |
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DIST-CO-RTE-PM | 01-MEN,HUM-101-R106.2/T106.8 |
Award Date | 09/15/2022 |
Closeout Date | 01/22/2024 |
Work Description | SOUTH FORK EEL RIVER BRIDGE SEISMIC |
Location Description | MENDOCINO AND HUMBOLDT COUNTIES NEAR COOKS VALLEY FROM 0.4 MILE SOUTH OF SOUTH FORK EEL RIVER BRIDGE TO 0.1 MILE NORTH OF ROUTE 271 |
QA Service Level | 1 (Verified on 06/27/2022) |
Sample Information
Sample Taken Date | 05/05/2023 | Sample Unique Key | 30 |
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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 | 05/08/2023 |
Sample type | Quality Assurance | A brief description of the sample | 6x12 concrete cylinders |
The quantity of what the sample constitutes | Barrier Slab | From where was the sample collected | Job Site |
First name of sampler or witnessed by | Ed | Last name of sampler or witnessed by | Ericson |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | C0152 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Mercer Fraser | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Concrete | The concrete mix design number | MFCLI 45Slag |
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The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | unknown | |
Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
A detailed description of where the material sample was collected | truck | 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 |
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No results found. |
Test File Attachments
DIME Test ID: 2023-05-05-30-1 CTM 521-June 2020 (Verified)