Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2024-03-21-6

Project Information

Project Identifiers
DEA: No Project
DIST-CO-RTE-PM---
Award DateNot set
Closeout Date11/01/2022
Work DescriptionSpecial project identifier for material not associated with a project
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date03/21/2024 Sample Unique Key6
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 testingNot set
Sample typeQuality Assurance A brief description of the sample4x8 concrete cylinders
The quantity of what the sample constitutesOne Sample Every 100 CY From where was the sample collectedJob Site
First name of sampler or witnessed byBrian Last name of sampler or witnessed byCinkutis
Title of samplerS Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTidewater Starry pit Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameAbutment no. 4

Material Information

Material TypeConcrete The concrete mix design numberE
The truck number from where the sample was collected30 The batch plant ticket number from where the sample was collected12343
Concrete batch plantTidewater Contractors The fabricator/manufacturer designation for the sampleTidewater
A detailed description of where the material sample was collectedDischard fron concrete truck into wheelbarrow. 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
No results found.

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments