Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2023-06-30-2
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993141 DEA: 060V1204 EFIS: 0616000207 |
|---|---|
| DIST-CO-RTE-PM | 06-MAD-99-R6.9/R7.6 |
| Award Date | 06/22/2022 |
| Closeout Date | Not set |
| Work Description | Cottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS. |
| Location Description | MADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING |
| QA Service Level | 1 (Verified on 07/28/2021) |
Sample Information
| Sample Taken Date | 06/30/2023 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | Department Acceptance | A brief description of the sample | 1x4, Sand |
| The quantity of what the sample constitutes | 2 bags 1x4, Sand | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Tomas | Last name of sampler or witnessed by | Silva |
| Title of sampler | TET | Telephone number of sampler | 559 3413953 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CVC Chowchilla | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-24-0045 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | A detailed description of where the material sample was collected | Conveyor Belt | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | 3802 | Lot number | |
| Sublot number | Aggregate Mix Number |
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. | |||