Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2016-10-07-9

Project Information

Project IdentifiersProject ID: 209950
DEA: 080N56U4
EFIS: 0813000176
DIST-CO-RTE-PM08-SBD-40-R94.7/R99.7
Award Date01/22/2015
Closeout Date09/17/2018
Work DescriptionBRIDGE REPLACEMENTS.
Location DescriptionSAN BERNARDINO COUNTY NEAR ESSEX AT HALLER WASH BRIDGE AT ROJO WASH BRIDGE AND AT CLIPPER VALLEY WASH BRIDGE
QA Service Level1 (Verified on 04/29/2015)

Sample Information

Sample Taken Date10/07/2016 Sample Unique Key9
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 testing10/17/2016
Sample typeQuality Control A brief description of the sample6X12
The quantity of what the sample constitutes2 From where was the sample collectedJob Site
First name of sampler or witnessed byROBERT Last name of sampler or witnessed byBERSBACH
Title of samplerASR Telephone number of sampler
Laboratory sample identification907-07 Linked DIME Sample ID
The fabricator/manufacturer/facility nameROBERTSONS Transportation Laboratory (TL) Number07
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierCLIPPER VALLEY WASH
Structure namePIER 2 FOOTING

Material Information

Material TypeConcrete The concrete mix design numberRRM15027
The truck number from where the sample was collected1911 The batch plant ticket number from where the sample was collected2256311
Concrete batch plant The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedLOAD 5 Where the material sample would have been placed if not sampled
From Lot No. Bag Lot No.

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2016-10-07-9-1ASTM C39-17a: Standard Test Method for Compressive Strength of Cylindrical Concrete SpecimensMatthew ClaytonCT - Southern Regional Laboratory11/04/2016Matthew Clayton
Yes
11/04/2016