Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2023-10-20-95
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Project Information
| Project Identifiers | Project ID: 994929 DEA: 034J6804 EFIS: 0323000228 |
|---|---|
| DIST-CO-RTE-PM | 03-YOL-128-1/6 |
| Award Date | 05/05/2023 |
| Closeout Date | Not set |
| Work Description | Not set |
| Location Description | Not set |
| QA Service Level | 1 (Verified on 06/26/2023) |
Sample Information
| Sample Taken Date | 10/20/2023 | Sample Unique Key | 95 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | No | Date that the sample was received by the laboratory/organization performing the testing | 10/20/2023 |
| Sample type | Quality Assurance | A brief description of the sample | 4 qt Cement Grout |
| The quantity of what the sample constitutes | 4 qt Cement Grout | From where was the sample collected | Source |
| First name of sampler or witnessed by | Phillip | Last name of sampler or witnessed by | Asher |
| Title of sampler | Assistant Structures Rep | Telephone number of sampler | 916-768-8293 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Drill Tech | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | 22-E0007 | |
| Structure name | RTE 128 Retaining Wall @ PM 2.25 |
Material Information
| Material Type | Concrete | The concrete mix design number | NA |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | NA | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Collected from the end of the hose coming from the grout pump. | 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 |
|---|---|---|---|---|---|---|---|---|
| 2023-10-20-95-1 | CTM 541-November 2010: Method of Test for Flow of Grout Mixtures (Flow Cone Method) | Phillip Asher III, CT D03 - Olivehurst Northern Regional Laboratory | 10/20/2023 | Phillip Asher III | No | Info |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-10-20-95-1 CTM 541-November 2010