Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2023-11-08-41
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Project Information
| Project Identifiers | Project ID: 994579 DEA: 070W4004 EFIS: 0722000046 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-101-30.9/R36.3;R40.6/R43.6 |
| Award Date | 05/16/2023 |
| Closeout Date | Not set |
| Work Description | CONCRETE PAVEMENT SLABS REPLACEMENT & SLURRY SHOULDER. |
| Location Description | VENTURA COUNTY IN AND NEAR VENTURA FROM VENTURA RIVER BRIDGE TO 0.4 MILE SOUTH OF PADRE JUAN CANYON ROAD OVERCROSSING AND FROM 0.4 MILE NORTH OF PUNTA GORDA PEDESTRIAN UNDERCROSSING TO BATES ROAD UNDERCROSSING. |
| QA Service Level | 1 (Verified on 07/24/2023) |
Sample Information
| Sample Taken Date | 11/08/2023 | Sample Unique Key | 41 |
|---|---|---|---|
| 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 | 11/08/2023 |
| Sample type | Acceptance | A brief description of the sample | 1" X #4 |
| The quantity of what the sample constitutes | 150 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Kevin | Last name of sampler or witnessed by | Hopkins |
| Title of sampler | Plant Inspector | Telephone number of sampler | |
| Laboratory sample identification | KH101A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | SHORTLOAD CONCRETE INC | Transportation Laboratory (TL) Number | C110823A |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0046 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | The fabricator/manufacturer designation for the sample | ||
| The plant number | Shortload Volumetric Ventura | A detailed description of where the material sample was collected | Stockpile @ Yard |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | CTS-65-GBR | Lot number | |
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-11-08-41-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-11-08-41-2 CTM 227-December 2014 (Verified)