Sample Record

Owner Lab

  • CT D03 - Chico Field Laboratory

DIME Sample ID 2023-08-01-41

Project Information

Project IdentifiersProject ID: 993253
DEA: 033F0604
EFIS: 0312000052
Award Date02/02/2022
Closeout DateNot set
Work DescriptionNot set
Location DescriptionNot set
QA Service Level1 (Verified on 04/08/2022)

Sample Information

Sample Taken Date08/01/2023 Sample Unique Key41
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 testing08/03/2023
Sample typeDepartment Acceptance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutesAbutment-1 From where was the sample collectedJob Site
First name of sampler or witnessed byMaggie Last name of sampler or witnessed byMcNally
Title of samplerASR Telephone number of sampler
Laboratory sample identification23-128 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMathews Readymix Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameButte City Bridge Br HWY 162

Material Information

Material TypeConcrete The concrete mix design number06315P15
The truck number from where the sample was collected000000 The batch plant ticket number from where the sample was collected000000
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedAbutment -1 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