Sample Record
Owner Lab
- MCM Construction, Inc.
DIME Sample ID 2023-10-24-111
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 994245 DEA: 051H4304 EFIS: 0516000073 |
|---|---|
| DIST-CO-RTE-PM | 05-SB-101-21.4/21.9 |
| Award Date | 03/02/2023 |
| Closeout Date | Not set |
| Work Description | San Jose Creek Bridge replacement |
| Location Description | SANTA BARBARA COUNTY IN GOLETA FROM ROUTE 101/217 SEPARATION TO 0.3 MILE NORTH OF SAN JOSE CREEK BRIDGE |
| QA Service Level | 1 (Verified on 09/19/2022) |
Sample Information
| Sample Taken Date | 10/24/2023 | Sample Unique Key | 111 |
|---|---|---|---|
| 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 testing | 10/25/2023 |
| Sample type | Quality Control | A brief description of the sample | CIDH concrete |
| The quantity of what the sample constitutes | 18 CY | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Peter | Last name of sampler or witnessed by | Kim |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CEMEX | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | San Jose Creek Bridge (NB) |
Material Information
| Material Type | Concrete | The concrete mix design number | 1610898 |
|---|---|---|---|
| The truck number from where the sample was collected | The batch plant ticket number from where the sample was collected | 30985838 | |
| Concrete batch plant | The fabricator/manufacturer designation for the sample | ||
| A detailed description of where the material sample was collected | Concrete pump hopper | 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 |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||