Sample Record for 2025-05-06-104
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000602 DEA: 040K6404 EFIS: 0416000112
QA Service Level: 1
DIST-CO-RTE-PM: 04-SOL-80-15.9/30.2
Work Description: COLD PLANE, OVERLAY, MGS, RAMP METERING, LIGHTING AND SIGNAL.
Location Description: SOLANO COUNTY ON ROUTE 80 IN AND NEAR FAIRFIELD AND VACAVILLE AT VARIOUS LOCATIONS FROM 1.5 MILES EAST OF SUISUN VALLEY ROAD OVERCROSSING TO 0.8 MILE EAST OF LEISURE TOWN ROAD OVERCROSSING.
Contractor Name: O.C. JONES & SONS, INC.
Contractor Address: Unknown
Resident Engineer: Justen Tatum Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2025-05-06-104
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Concord Field Laboratory
Sample Organization Contact: (510) 714-7019
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 05/06/2025
Date that the sample was received by the laboratory/organization performing the testing: 05/06/2025
The quantity of what the sample constitutes: 100Tons
A brief description of the sample: 3/4"RHMA-G
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Woodland
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-57-0004
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: At the plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number: 1
Sublot number: 2
Aggregate Mix Number:
Test Results
