Sample Record

Owner Lab

  • CT D03 - Chico Field Laboratory

DIME Sample ID 2023-06-28-30

Project Information

Project IdentifiersProject ID: 213466
DEA: 034H4404
Award Date06/25/2018
Closeout Date05/05/2020
Work DescriptionReplace 72" CMP culvert and invert pave the length of the culvert
Location DescriptionNot set
QA Service Level1 (Verified on 01/08/2019)

Sample Information

Sample Taken Date06/28/2023 Sample Unique Key30
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 testing06/30/2023
Sample typeDepartment Acceptance A brief description of the sampleTextured Wall Pile 154-144
The quantity of what the sample constitutes3 4x8 concrete cylinders From where was the sample collectedJob Site
First name of sampler or witnessed byJason Last name of sampler or witnessed byCharmberry
Title of samplerASR Telephone number of sampler
Laboratory sample identification23-118 Linked DIME Sample ID
The fabricator/manufacturer/facility nameShasta Ready Mix Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameSolder Pile retaining Wall

Material Information

Material TypeConcrete The concrete mix design numberCT-67SSLA50
The truck number from where the sample was collected41 The batch plant ticket number from where the sample was collected77946
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedTextured 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 IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments