Sample Record
Owner Lab
- Myers and Sons Construction
DIME Sample ID 2023-11-21-51
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993856 DEA: 042J7304 EFIS: 0415000004 |
|---|---|
| DIST-CO-RTE-PM | 04-SM-101-6.7/7.6 |
| Award Date | 03/20/2023 |
| Closeout Date | Not set |
| Work Description | SM 101 Cordilleras Crk Br Replacement |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/27/2022) |
Sample Information
| Sample Taken Date | 11/21/2023 | Sample Unique Key | 51 |
|---|---|---|---|
| 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 | 11/22/2023 |
| Sample type | Quality Control | A brief description of the sample | Type II Cement w/1 inch Agg |
| The quantity of what the sample constitutes | 9 CY concrete | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Steve | Last name of sampler or witnessed by | Olsen |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichert Vernalis | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Pulgas Creek Bridge |
Material Information
| Material Type | Concrete | The concrete mix design number | CTS-72-EHI |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 000000 | |
| Concrete batch plant | Teichert Vernalis Aggregates | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Back of truck discharge chute | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
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 |
|---|---|---|---|
| Cordilleras_Creek_Bridge_11-21-2023_[Concrete] | 12/14/2023 | Info |