Sample Record for 2024-09-26-2
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000261 DEA: 010M6704 EFIS: 0123000054
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-R27.9/31.2
Work Description: MICRO-SURFACING, PAVEMENT DELINEATION, AND REPLACE AC SURFACING.
Location Description: DEL NORTE COUNTY NEAR CRESCENT CITY FROM WASHINGTON BOULEVARD OVERCROSSING TO ELK VALLEY CROSS ROAD
Contractor Name: DOOLITTLE CONSTRUCTION, LLC DBA DOOLITTLE ROAD CONSTRUCTION
Contractor Address: Unknown
Resident Engineer: Aaron Valley Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2024-09-26-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Crescent City Field Laboratory
Sample Organization Contact: (707) 496-5581
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 09/26/2024
Date that the sample was received by the laboratory/organization performing the testing: 09/24/2024
The quantity of what the sample constitutes: 2
A brief description of the sample: Aggregate Type III for Slurry Seal
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: kirtland road agg plant
Material Information
Source Identification (SMARA, name of Pit or Job Site): 03-26-16-0
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: sample was collected at the crecent city fairgrounds stagng area
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
