Sample Record for 2026-04-22-13
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1000997 DEA: 010J2104 EFIS: 0118000190
QA Service Level: 1
DIST-CO-RTE-PM: 01-DN-101-R2.6/23.9
Work Description: RHMA, HMA, AND COLD PLANE ASPHALT CONCRETE PAVEMENT.
Location Description: DEL NORTE COUNTY IN AND NEAR KLAMATH FROM 1.2 MILES SOUTH OF KLAMATH RIVER OVERFLOW TO 1.1 MILE NORTH OF HAMILTON ROAD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: P O BOX 1006, EUREKA, CA 95502-1006
Resident Engineer: Aaron Valley Structure Rep.: Joshua Erler
Sample Information
DIME Sample ID: 2026-04-22-13
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - Boyd Road Field Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 04/22/2026
Date that the sample was received by the laboratory/organization performing the testing: 04/22/2026
The quantity of what the sample constitutes: 2
A brief description of the sample: 1/2 in cold feed
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser Boyd Road
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-12-0010
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: hot plant before drum
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
