Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 1000561 DEA: 010J8904 EFIS: 0119000119
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-36-3.9/6.0
Work Description: HOT MIX ASPHALT, AGGREGATE BASE, AND STRUCTURAL CONCRETE.
Location Description: HUMBOLDT COUNTY AT CARLOTTA FROM 0.2 MILE WEST OF FISHER ROAD TO 0.2 MILE WEST OF WILDER ROAD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: 200 Dinsmore Dr., Fortuna, CA 95540
Resident Engineer: Cody Long Structure Rep.: Shantanu Nalawade
DIME Sample ID: 2025-09-18-43
TL Number from the TL Form:
Sample Submitted By Organization: Con-Fab California Corporation - Lathrop
Sample Organization Contact: (209) 249-4700
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 09/18/2025
Date that the sample was received by the laboratory/organization performing the testing: 09/18/2025
The quantity of what the sample constitutes: 1 Bucket of 1/2", 1 Bucket of 3/8", One Bucket of Sand
A brief description of the sample: 1 Bucket of 1/2", 1 Bucket of 3/8", One Bucket of Sand
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: ConFab Lathrop
Source Identification (SMARA, name of Pit or Job Site): Confab California Lathrop
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: Plant Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: VER90LV
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2025-09-18-43-1
Test Method: ASTM C566-19: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
Verified Date: 09/24/2025
Date Tested: 09/18/2025
Submitted By Organization: Con-Fab California Corporation - Lathrop
Organization Address: 1910 Lathrop Road,
Organization City: Lathrop
Organization State: CA
Organization Zipcode: 95330
Organization Email: dannyc@confabca.com
Organization Phone: (209) 249-4717
General Comments for this Test: Sand: 3.8%
1/2": 0.52%
3/8": 0.60%
Test Result Compliance:
Additional Comments When Verified:
|
Total evaporable moisture content
|
3.8 %
|
