Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2023-07-28-28
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Project Information
| Project Identifiers | Project ID: 993715 DEA: 010G1404 EFIS: 0116000129 |
|---|---|
| DIST-CO-RTE-PM | 01-HUM-96,169-VAR |
| Award Date | 11/16/2022 |
| Closeout Date | Not set |
| Work Description | HUM 96-169 5 Bridges Rail Upgrade (Do not include in project name: STRUCTURAL STEEL, CONCRETE BARRIER, POLYESTER CONCRETE OVERLAY) |
| Location Description | HUMBOLDT COUNTY ON ROUTES 96 AND 169 AT VARIOUS LOCATIONS (Bridge Nos. 04-0215, 04-0059, 04-0063, 04-0225, 04-0061) |
| QA Service Level | 1 (Verified on 04/19/2022) |
Sample Information
| Sample Taken Date | 07/28/2023 | Sample Unique Key | 28 |
|---|---|---|---|
| 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 | 07/29/2023 |
| Sample type | Quality Assurance | A brief description of the sample | Structural concrete polymer fiber |
| The quantity of what the sample constitutes | 16 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Joe | Last name of sampler or witnessed by | Pedroni |
| Title of sampler | ASR | Telephone number of sampler | 7075106120 |
| Laboratory sample identification | C0163 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Mercer Fraser Willow Creek Plant | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 12-04-0059 | |
| Structure name | Aikens Creek Bridge |
Material Information
| Material Type | Concrete | The concrete mix design number | MFWCBRDKSLAG |
|---|---|---|---|
| The truck number from where the sample was collected | 695 | The batch plant ticket number from where the sample was collected | WC01209 |
| Concrete batch plant | Willow Creek | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Discharge chute from back of truck | Where the material sample would have been placed if not sampled | Aikens Creek Bridge Deck Overhang |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-07-28-28-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2023-07-28-28-2 CTM 556-March 2016 (Verified)
DIME Test ID: 2023-07-28-28-3 CTM 557-June 2020 (Verified)