Sample Record

Owner Labs

  • CT SC - 3672 - Petaluma
  • CT HQ - Sacramento Concrete Testing Laboratory
  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2016-12-27-1

Project Information

Project IdentifiersProject ID: 210871
DEA: 044G4604
EFIS: 0412000480
DIST-CO-RTE-PM04-MRN-101-1.5/14.0
Award Date01/28/2016
Closeout Date10/17/2019
Work DescriptionREMOVE EXISTING AND CONSTRUCT NEW BRIDGE RAILINGS.
Location DescriptionIN MARIN COUNTY, AT VARIOUS LOCATION, FROM SPENCER AVE OVERCROSSING TO NORTH BRANCHGALLINAS CREEK BRIDGE
QA Service Level1 (Verified on 01/12/2016)

Sample Information

Sample Taken Date12/27/2016 Sample Unique Key1
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 sampleprotj
The quantity of what the sample constitutes250 From where was the sample collectedJob Site
First name of sampler or witnessed byohj Last name of sampler or witnessed byg
Title of samplert Telephone number of sampler5103857179
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namese 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 number4201a
The truck number from where the sample was collected The batch plant ticket number from where the sample was collected428132
Concrete batch plant04 The fabricator/manufacturer designation for the sample
A detailed description of where the material sample was collectedCHUTE FROM 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
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Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments