Sample Record

Owner Labs

  • CT SC Sub-unit 3674-102
  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2015-12-11-3

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/01/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date12/11/2015 Sample Unique Key3
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Assurance A brief description of the sample2 6x12 concrete cylinders
The quantity of what the sample constitutes22 CY From where was the sample collectedJob Site
First name of sampler or witnessed byJeremy Last name of sampler or witnessed byLight
Title of samplerTEC Telephone number of sampler510)385-7179
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameShamrock Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier200295
Structure namePetaluma River Bridge

Material Information

Material TypeConcrete The concrete mix design number4100A
The truck number from where the sample was collected1954 The batch plant ticket number from where the sample was collected433573
Concrete batch plant04 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 sampledIntermidiate Diaphragms Spans 1 2 Stage 2
From Lot No.Not set Bag Lot No.Not set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2015-12-11-3-1ASTM C39-10: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensMCM CT HQ - Sacramento Concrete Testing Laboratory01/08/2016Mike Mullins
Yes
01/08/2016