Sample Record

Owner Lab

  • CT D04 - Richmond Field Laboratory

DIME Sample ID 2024-03-05-46

Project Information

Project IdentifiersProject ID: 994803
DEA: 043J0704
EFIS: 0415000077
DIST-CO-RTE-PM04-CC-80-10.1/13.5
Award Date03/10/2023
Closeout DateNot set
Work DescriptionRemove PCC and AC, place PCP and AC Resurfacing.
Location DescriptionConstruction on State Highway in Contra Costa County in Hercules and Crockett from Route 80/4 separation to 0.1 mile west of Crockett Viaduct.
QA Service Level1 (Verified on 05/10/2023)

Sample Information

Sample Taken Date03/05/2024 Sample Unique Key46
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 testing03/05/2024
Sample typeQuality Assurance A brief description of the sample1x 4 PCC Aggregates +Sand
The quantity of what the sample constitutesTwo Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byIGNACIO Last name of sampler or witnessed byARECHIGA
Title of samplerLab Technician Telephone number of sampler5102077252
Laboratory sample identificationRich_24_014 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVanguard Mobile San Pablo Plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameBarrier

Material Information

Material TypeConcrete The concrete mix design number590MAC
The truck number from where the sample was collected1076 The batch plant ticket number from where the sample was collected1076
Concrete batch plantVanguard The fabricator/manufacturer designation for the samplestock pile
A detailed description of where the material sample was collectedyard stock pile. Where the material sample would have been placed if not sampledyes
From Lot No.stockpile 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