Sample Record
Owner Lab
- CT HQ - Sacramento Concrete Testing Laboratory
DIME Sample ID 2016-05-27-13
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Project Information
| Project Identifiers | Project ID: 209812 DEA: 04264H34 EFIS: 0414000221 COOP: 042535 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-18.6/27.7 |
| Award Date | 11/05/2015 |
| Closeout Date | 12/22/2017 |
| Work Description | PHASE 1 OF MARIN -SONOMA NARROWS HIGH OCCUPANCY VEHICLE WIDENING PROJECT I |
| Location Description | IN MARIN COUNTY IN NOVATO AND NEAR BURDELL AT VARIOUS LOCATIONS FROM SOUTH NOVATO BOULEVARD OVERCROSSINGTO 0.3 MILE NORTH OF REDWOOD LANDFILL OVERCROSSING |
| QA Service Level | 1 (Verified on 09/17/2015) |
Sample Information
| Sample Taken Date | 05/27/2016 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 06/03/2016 |
| Sample type | Quality Assurance | A brief description of the sample | 4 6x12 concrete cylinders |
| The quantity of what the sample constitutes | 2 sets | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Jeremy | Last name of sampler or witnessed by | Light |
| Title of sampler | ASR | Telephone number of sampler | 510-393-9273 |
| Laboratory sample identification | Unknown | Linked DIME Sample ID | Unknown |
| The fabricator/manufacturer/facility name | Shamrock | Transportation Laboratory (TL) Number | Unknown |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Unknown | Structure unique identifier | Unknown |
| Structure name | Olive Ave UC Mod |
Material Information
| Material Type | Concrete | The concrete mix design number | 3172GG |
|---|---|---|---|
| The truck number from where the sample was collected | 1214 | The batch plant ticket number from where the sample was collected | 439199 |
| Concrete batch plant | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| A detailed description of where the material sample was collected | from chute | Where the material sample would have been placed if not sampled | Sound Wall Barrier |
| From Lot No. | Unknown | Bag Lot No. | Unknown |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||