Sample Record
Owner Lab
- CT D03 - Chico Field Laboratory
DIME Sample ID 2023-06-28-30
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213466 DEA: 034H4404 |
|---|---|
| DIST-CO-RTE-PM | 03-PLA-80-50.78 |
| Award Date | 06/25/2018 |
| Closeout Date | 05/05/2020 |
| Work Description | Replace 72" CMP culvert and invert pave the length of the culvert |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 01/08/2019) |
Sample Information
| Sample Taken Date | 06/28/2023 | Sample Unique Key | 30 |
|---|---|---|---|
| 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 | 06/30/2023 |
| Sample type | Acceptance | A brief description of the sample | Textured Wall Pile 154-144 |
| The quantity of what the sample constitutes | 3 4x8 concrete cylinders | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jason | Last name of sampler or witnessed by | Charmberry |
| Title of sampler | ASR | Telephone number of sampler | |
| Laboratory sample identification | 23-118 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Shasta Ready Mix | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Solder Pile retaining Wall |
Material Information
| Material Type | Concrete | The concrete mix design number | CT-67SSLA50 |
|---|---|---|---|
| The truck number from where the sample was collected | 41 | The batch plant ticket number from where the sample was collected | 77946 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Textured Wall pile 154- plie 144 | 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. | |||