Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2024-01-05-27

Project Information

Project IdentifiersProject ID: 994109
DEA: 060W1704
EFIS: 0617000103
DIST-CO-RTE-PM06-FRE-41-R27.4/R28.5
Award Date11/10/2022
Closeout DateNot set
Work DescriptionREMOVE AC PAVEMENT, WIDEN TRAVEL WAY, AND CONSTRUCT RETAINING WALL.
Location DescriptionFRESNO COUNTY IN FRESNO FROM 0.1 MILE SOUTH OF ASHLAN AVENUE OVERCROSSING TO SHAW AVENUE OVERCROSSING
QA Service Level1 (Verified on 07/13/2022)

Sample Information

Sample Taken Date01/05/2024 Sample Unique Key27
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 testing01/08/2024
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 byCristian Last name of sampler or witnessed bySuarez
Title of samplerAssistant Structure Representative Telephone number of sampler5592594817
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameBuilders Concrete Ready Mix Plant Sanger Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameGround Anchor Wall 3

Material Information

Material TypeConcrete The concrete mix design numberND22023
The truck number from where the sample was collected4 The batch plant ticket number from where the sample was collected111335822
Concrete batch plantBuilders Concrete The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedWall 3 Wall Facing Station 33+50 to 36+15 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