Sample Record
Owner Lab
- CT D06 - Millbrook Field Laboratory
DIME Sample ID 2023-12-16-2
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Project Information
| Project Identifiers | Project ID: 994109 DEA: 060W1704 EFIS: 0617000103 |
|---|---|
| DIST-CO-RTE-PM | 06-FRE-41-R27.4/R28.5 |
| Award Date | 11/10/2022 |
| Closeout Date | Not set |
| Work Description | REMOVE AC PAVEMENT, WIDEN TRAVEL WAY, AND CONSTRUCT RETAINING WALL. |
| Location Description | FRESNO COUNTY IN FRESNO FROM 0.1 MILE SOUTH OF ASHLAN AVENUE OVERCROSSING TO SHAW AVENUE OVERCROSSING |
| QA Service Level | 1 (Verified on 07/13/2022) |
Sample Information
| Sample Taken Date | 12/16/2023 | Sample Unique Key | 2 |
|---|---|---|---|
| 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 | 12/18/2023 |
| Sample type | Department Acceptance | A brief description of the sample | PCC cylinders |
| The quantity of what the sample constitutes | 300 | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Gerzon | Last name of sampler or witnessed by | Ceja |
| Title of sampler | Assistant Structure Representative | Telephone number of sampler | 5599172487 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Builders Concrete Ready Mix Plant Sanger | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Soil Nail Wall 3 |
Material Information
| Material Type | Concrete | The concrete mix design number | ND22023 |
|---|---|---|---|
| The truck number from where the sample was collected | 3 | The batch plant ticket number from where the sample was collected | 111334953 |
| Concrete batch plant | Builders Concrete | The fabricator/manufacturer designation for the sample | |
| A detailed description of where the material sample was collected | Wall 3 Wall Facing 4th Lift | Where the material sample would have been placed if not sampled | |
| From Lot No. | Bag Lot No. |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-12-16-2-1 CTM 521-June 2020 (Verified)
DIME Test ID: 2023-12-16-2-2 CTM 521-June 2020 (Verified)