Sample Record

Owner Lab

  • CT D01 - District 1 Materials Laboratory

DIME Sample ID 2023-05-05-30

Project Information

Project IdentifiersProject ID: 994062
DEA: 010F5104
EFIS: 0116000015
DIST-CO-RTE-PM01-MEN,HUM-101-R106.2/T106.8
Award Date09/15/2022
Closeout Date01/22/2024
Work DescriptionSOUTH FORK EEL RIVER BRIDGE SEISMIC
Location DescriptionMENDOCINO 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 Level1 (Verified on 06/27/2022)

Sample Information

Sample Taken Date05/05/2023 Sample Unique Key30
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 testing05/08/2023
Sample typeQuality Assurance A brief description of the sample6x12 concrete cylinders
The quantity of what the sample constitutesBarrier Slab From where was the sample collectedJob Site
First name of sampler or witnessed byEd Last name of sampler or witnessed byEricson
Title of sampler Telephone number of sampler
Laboratory sample identificationC0152 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMercer Fraser 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 numberMFCLI 45Slag
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedunknown
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedtruck 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
2023-05-05-30-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJamie Kelley, CT D01 - District 1 Materials Laboratory06/16/2023Jamie Kelley
Yes
06/16/202342 day Break

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-05-05-30-1 CTM 521-June 2020 (Verified)