Sample Record

Owner Labs

  • CT HQ - Sacramento Structural Materials Testing Laboratory
  • CT SC - 3672 - Petaluma

DIME Sample ID 2023-05-17-20

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
QA Service Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date05/17/2023 Sample Unique Key20
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 testing05/17/2023
Sample typeQuality Assurance A brief description of the sample3 4x8 concrete cylinder molds
The quantity of what the sample constitutesConcrete placed in 836 and 836A Barrier Rail on Olive Ave Bridge 165ft From where was the sample collectedJob Site
First name of sampler or witnessed byJeremy Last name of sampler or witnessed byLight
Title of samplerStructure Representative Telephone number of sampler15103939273
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Materials Petaluma Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier27-0092L
Structure nameOlive Ave UC - Widen SB

Material Information

Material TypeConcrete The concrete mix design number3728LV
The truck number from where the sample was collected2452 The batch plant ticket number from where the sample was collected343693
Concrete batch plant138 Petaluma The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampled836 and 836A Barrier Rail on Olive Ave Overcrossing
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-05-17-20-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensSA, CT HQ - Sacramento Concrete Testing Laboratory06/14/2023SA
Yes
06/14/2023

Sample File Attachments

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Test File Attachments


DIME Test ID: 2023-05-17-20-1 ASTM C39-17a (Verified)