Sample Record

Owner Lab

  • CT HQ - QASI Sacramento Field Office

DIME Sample ID 2024-05-12-16

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 Date05/12/2024 Sample Unique Key16
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 testing05/12/2024
Sample typeQuality Control A brief description of the samplePatching mix
The quantity of what the sample constitutes31 CY From where was the sample collectedFabricator
First name of sampler or witnessed byPetetr Last name of sampler or witnessed byHarvey
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameKie-Con Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeConcrete The concrete mix design number123
The truck number from where the sample was collected The batch plant ticket number from where the sample was collectedNA
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedMIX TRUCK 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
No results found.

Test File Attachments