Sample Record

Owner Lab

  • CT D01 - Crescent City Field Laboratory

DIME Sample ID 2024-01-22-4

Project Information

Project IdentifiersProject ID: 215620
DEA: 01436404
EFIS: 0100000193
DIST-CO-RTE-PM01-DN-101-35.8/36.5
Award Date07/11/2022
Closeout DateNot set
Work DescriptionDr. Fine Bridge Replacement
Location DescriptionDR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
QA Service Level1 (Verified on 03/26/2021)

Sample Information

Sample Taken Date01/22/2024 Sample Unique Key4
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 testing01/22/2024
Sample typeQuality Assurance A brief description of the sample3/4" Minus
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byGary Last name of sampler or witnessed byZamora
Title of samplerTransportation Engineer Telephone number of sampler707-666-5469
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTidewater/Hole Pit Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameDr. Fine

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)Tidewater/Hole Pit
The fabricator's/manufacturer's product name for the sample3/4" Minus The fabricator/manufacturer designation for the sample3/4" Minus
The plant number A detailed description of where the material sample was collectedStockpile @ plant
Where the material sample would have been placed if not sampledDetour Bridge Approaches Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments