Sample Record for 2023-05-08-98
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993804 DEA: 043J0624 EFIS: 0419000534
QA Service Level: 1
DIST-CO-RTE-PM: 04-SM-101-16.5/23.0
Work Description: COLD PLANE AND PLACE HMA, REPLACE GUARDRAIL AND CURB RAMPS.
Location Description: SAN MATEO COUNTY AT VARIOUS LOCATION FROM BROADWAY OVERCROSSING TO 0.2 MILE NORTH OF OYSTER POINT BOULEVARD OVERCROSSING
Contractor Name: Bay Cities Paving & Grading, Inc. (David Nott)
Contractor Address: 1450 Civic Ct. Bldg B #400, Concord CA, 94520
Resident Engineer: Douglas Inori Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2023-05-08-98
TL Number from the TL Form:
Sample Submitted By Organization: CT D06 - Millbrook Field Laboratory
Sample Organization Contact: (559) 341-3953
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 05/08/2023
Date that the sample was received by the laboratory/organization performing the testing: 05/08/2023
The quantity of what the sample constitutes: 0
A brief description of the sample: 1X#4 & 3/8 Coarse Agg
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: JJJ Redi-Mix Coalinga
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-10-0005
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: Jobsite Stockpile
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: HE4X4BM
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
