Sample Record
Owner Lab
- CT D02 - Yreka Field Laboratory
DIME Sample ID 2023-06-11-14
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 212498 DEA: 021H5204 EFIS: 0217000009 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-3,263-48.5/49.7 - 49.41 |
| Award Date | 06/09/2023 |
| Closeout Date | Not set |
| Work Description | Roadway Rehabilitation |
| Location Description | 02-Sis-3, 263-R46.8/R48.0, 49.07/49.41 |
| QA Service Level | 1 (Verified on 06/06/2017) |
Sample Information
| Sample Taken Date | 06/11/2023 | 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 | 06/22/2023 |
| Sample type | Acceptance | A brief description of the sample | Concrete beams |
| The quantity of what the sample constitutes | 82 yds | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Joe | Last name of sampler or witnessed by | Delgado |
| Title of sampler | Consultant Tester | Telephone number of sampler | |
| Laboratory sample identification | 6-13-23 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Meyers Batch Plant | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Concrete | The concrete mix design number | 800 RS |
|---|---|---|---|
| The truck number from where the sample was collected | Load 4 | The batch plant ticket number from where the sample was collected | tt45 |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | mixer truck chute | 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. | |||