Sample Record

Owner Lab

  • CT HQ - QASI Bay Area Field Office

DIME Sample ID 2023-09-19-1

Project Information

Project IdentifiersProject ID: 333101
DEA: 03TEST04
EFIS: 03TEST3101
DIST-CO-RTE-PM03---
Award Date10/01/2021
Closeout DateNot set
Work DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT WAS ADDED FOR E3101 DEVELOPMENT AND TESTING PURPOSES. DATA SUBMITTED FOR THIS PROJECT MUST NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level1 (Verified on 09/29/2021)

Sample Information

Sample Taken Date09/19/2023 Sample Unique Key1
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing09/19/2023
Sample typeQuality Control A brief description of the sampleproduction concrete
The quantity of what the sample constitutes1 voided slab From where was the sample collectedFabricator
First name of sampler or witnessed byAaron Last name of sampler or witnessed byFranklin
Title of sampler Telephone number of sampler8586990513
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKieCon Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design numbertest 1
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedTest
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedProbe in center 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
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments