Sample Record for 2025-07-29-61
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209109 DEA: 043G9004 EFIS: 0412000557 COOP: 042513
QA Service Level: 1
DIST-CO-RTE-PM: 04-SON-116,121-46.0/46.7,5.8/R7.4
Work Description: MODIFY EXISTING STATE ROUTE 116,121 BONNEAU ROAD INTERSECTION FROM A 4 WAY STOP CONTROLLED INTERSECTION TO A ROUNDABOUT AND SIGNALIZED INTERSECTION.
Location Description: SONOMA COUNTY
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Fabio La Serna Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-07-29-61
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Petaluma Field Laboratory
Sample Organization Contact: 510-385-7413
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 07/29/2025
Date that the sample was received by the laboratory/organization performing the testing: 07/29/2025
The quantity of what the sample constitutes: 3 Bags
A brief description of the sample: PCC Agg
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Superior Ready Mix
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-49-0004
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: Conveyor Belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number: 590CR2
Test Results
