Sample Record

Owner Lab

  • CT D01 - District 1 Materials Laboratory

DIME Sample ID 2023-05-31-8

Project Information

Project IdentifiersProject ID: 993715
DEA: 010G1404
EFIS: 0116000129
DIST-CO-RTE-PM01-HUM-96,169-VAR
Award Date11/16/2022
Closeout DateNot set
Work DescriptionHUM 96-169 5 Bridges Rail Upgrade (Do not include in project name: STRUCTURAL STEEL, CONCRETE BARRIER, POLYESTER CONCRETE OVERLAY)
Location DescriptionHUMBOLDT COUNTY ON ROUTES 96 AND 169 AT VARIOUS LOCATIONS (Bridge Nos. 04-0215, 04-0059, 04-0063, 04-0225, 04-0061)
QA Service Level1 (Verified on 04/19/2022)

Sample Information

Sample Taken Date05/31/2023 Sample Unique Key8
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 testing06/01/2023
Sample typeQuality Assurance A brief description of the samplePCC cylinders
The quantity of what the sample constitutes2 cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byJoe Last name of sampler or witnessed byPedroni
Title of samplerASR Telephone number of sampler
Laboratory sample identificationCO158 Linked DIME Sample ID
The fabricator/manufacturer/facility nameUnknown 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 numberE400FBR
The truck number from where the sample was collectedunknown 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 collectedCHUTE FROM 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
2023-05-31-8-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJamie Kelley, CT D01 - District 1 Materials Laboratory06/28/2023Jamie Kelley
Yes
06/28/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-05-31-8-1 CTM 521-June 2020 (Verified)