Sample Record for 2024-10-21-9
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 995286 DEA: 042Q5704 EFIS: 0419000026
QA Service Level: 1
DIST-CO-RTE-PM: 04-SCL-101,680-Var
Work Description: REPLACE STORMWATER PUMPS AND CONSTRUCT DRAINAGE BOXES.
Location Description: SANTA CLARA COUNTY IN AND NEAR MORGAN HILL AND SAN JOSE AT VARIOUS LOCATIONS
Contractor Name: DISNEY CONSTRUCTION, INC.
Contractor Address: 533 airport Blvd, Suite 120, Burlingame, CA 94010
Resident Engineer: Nim Patel Structure Rep.: Steve Gong
Sample Information
DIME Sample ID: 2024-10-21-9
TL Number from the TL Form:
Sample Submitted By Organization: Structure Cast
Sample Organization Contact: (661) 301-2624
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 10/21/2024
Date that the sample was received by the laboratory/organization performing the testing: 10/21/2024
The quantity of what the sample constitutes: 45 yd
A brief description of the sample: Aggregate
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: StructureCast
Material Information
Source Identification (SMARA, name of Pit or Job Site): Vulcan San Emidio
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: Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Test 1 of 1
DIME Test ID: 2024-10-21-9-1
Test Method: ASTM C136-19: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: Structure Cast
Organization Address: 8261 McCutchen Road ,
Organization City: Bakersfield
Organization State: CA
Organization Zipcode: 93311
Organization Email: brent@structurecast.com
Organization Phone: (661) 717-5464
Data has not been verified.
