Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2023-12-13-20
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Project Information
| Project Identifiers | Project ID: 993141 DEA: 060V1204 EFIS: 0616000207 |
|---|---|
| DIST-CO-RTE-PM | 06-MAD-99-R6.9/R7.6 |
| Award Date | 06/22/2022 |
| Closeout Date | Not set |
| Work Description | Cottonwood Creek Bridge Replacement - REPLACE BRIDGES AND CONSTRUCT RETAINING WALLS. |
| Location Description | MADERA COUNTY NEAR MADERA FROM 0.4 MILE SOUTH OF COTTONWOOD CREEK BRIDGE TO 0.1 MILE NORTH OF AVENUE 12 OVERCROSSING |
| QA Service Level | 1 (Verified on 07/28/2021) |
Sample Information
| Sample Taken Date | 12/13/2023 | Sample Unique Key | 20 |
|---|---|---|---|
| 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 | 12/13/2023 |
| Sample type | Department Acceptance | A brief description of the sample | Soil for structure backfill. |
| The quantity of what the sample constitutes | 1 bag Structure Backfill | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Noah | Last name of sampler or witnessed by | Hunt |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Security Paving company | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Soil | The fabricator's/manufacturer's product name for the sample | |
|---|---|---|---|
| The fabricator/manufacturer designation for the sample | A detailed description of where the material sample was collected | job site bridge abutment 1 | |
| Where the material sample would have been placed if not sampled |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-12-13-20-1 CTM 216-June 2011 (Verified)