Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2023-12-04-17

Project Information

Project IdentifiersProject ID: 212737
DEA: 060S8304
EFIS: 0615000046
DIST-CO-RTE-PM06-FRE-5-44.4-45.4
Award Date05/27/2022
Closeout DateNot set
Work DescriptionTUMEY GULCH ABUTMENT REHAB BR# 42-0246L/R.
Location DescriptionIN FRESNO COUNTY AT TUMEY GULCH.
QA Service Level1 (Verified on 09/25/2018)

Sample Information

Sample Taken Date12/04/2023 Sample Unique Key17
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 testing12/04/2023
Sample typeDepartment Acceptance A brief description of the samplePCC cylinders
The quantity of what the sample constitutes300 From where was the sample collectedJob Site
First name of sampler or witnessed byMartin Last name of sampler or witnessed byGarcia
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDon Chapin - Los Banos Plant 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 numberG67S34S
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected420830
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedConcrete from wheelbarrow 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