Sample Record

Owner Lab

  • CT D01 - District 1 Materials Laboratory

DIME Sample ID 2023-08-14-44

Project Information

Project IdentifiersProject ID: 993715
DEA: 010G1404
EFIS: 0116000129
DIST-CO-RTE-PM01-HUM-96,169-VAR
Award Date11/16/2022
Closeout DateNot set
Work DescriptionHUM 96-169 5 Bridges Rail Upgrade (Do not include in project name: STRUCTURAL STEEL, CONCRETE BARRIER, POLYESTER CONCRETE OVERLAY)
Location DescriptionHUMBOLDT COUNTY ON ROUTES 96 AND 169 AT VARIOUS LOCATIONS (Bridge Nos. 04-0215, 04-0059, 04-0063, 04-0225, 04-0061)
QA Service Level1 (Verified on 04/19/2022)

Sample Information

Sample Taken Date08/14/2023 Sample Unique Key44
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 testing08/15/2023
Sample typeQuality Assurance A brief description of the sample3 4x8 cylinders
The quantity of what the sample constitutesunknown From where was the sample collectedJob Site
First name of sampler or witnessed byJoe Last name of sampler or witnessed byPedroni
Title of samplerASR Telephone number of sampler7075106120
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMercer Fraser Company, Willow Creek Plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier12-04-0063
Structure nameBluff Creek Bridge

Material Information

Material TypeConcrete The concrete mix design numberMFCL1-45SLAGWC+SRA
The truck number from where the sample was collected682 The batch plant ticket number from where the sample was collectedWC01557
Concrete batch plantWillow Creek Mercer Fraser Plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM TRUCK Where the material sample would have been placed if not sampledApproach Slab LF
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-08-14-44-1CTM 521-June 2020: Method of Test for Compressive Strength of Molded Concrete CylindersJamie Kelley, CT D01 - District 1 Materials Laboratory09/11/2023Leif Ayres
Yes
09/19/2023

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-08-14-44-1 CTM 521-June 2020 (Verified)