Sample Record
Owner Lab
- CT D09 - Bishop Field Laboratory
DIME Sample ID 2023-06-19-14
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994363 DEA: 09391504 EFIS: 0922000013 MINOR: 09A0893 |
|---|---|
| DIST-CO-RTE-PM | 09-INY,MNO,MNO,MNO,MNO-395,395,6,6-R18.08, 63.55, 21.14, 27.4 |
| Award Date | 08/05/2022 |
| Closeout Date | 01/02/2023 |
| Work Description | District CCTV and RWIS Replacements |
| Location Description | INYO AND MONO COUNTIES ON HIGHWAYS 395 AND 6 |
| QA Service Level | 1 (Verified on 10/26/2022) |
Sample Information
| Sample Taken Date | 06/19/2023 | Sample Unique Key | 14 |
|---|---|---|---|
| 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 | 06/20/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 4 PCC Cylinders |
| The quantity of what the sample constitutes | 2 yards | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jerid | Last name of sampler or witnessed by | Kupelian |
| Title of sampler | QA Material Tester | Telephone number of sampler | 8058042482 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | 711 Materials Ridgecrest | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | location 1 |
Material Information
| Material Type | Concrete | The concrete mix design number | 628211A |
|---|---|---|---|
| The truck number from where the sample was collected | 86026 | The batch plant ticket number from where the sample was collected | 835741 |
| Concrete batch plant | 711 Materials Ridgecrest | The fabricator/manufacturer designation for the sample | concrete plant |
| A detailed description of where the material sample was collected | CHUTE FROM TRUCK | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||