Sample Record for 2026-09-15-46
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 1001369 DEA: 010K1504 EFIS: 0120000035
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-125.2/R126.1
Work Description: EARTHWORK, HMA-A, DRAINAGE, AND HIGH FRICTION SURFACE TREATMENT.
Location Description: HUMBOLDT COUNTY NEAR ORICK FROM 0.9 MILE SOUTH TO SOUTH PRAIRIE CREEK PARK UNDERCROSSING
Contractor Name: G R SUNDBERG INC
Contractor Address: 5211 Boyd Road, Arcata, CA 95521
Resident Engineer: Ryan Dunne Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2026-09-15-46
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: 09/15/2026
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 2 bags
A brief description of the sample: 1/2 in Agg
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tidewater Smith River
Material Information
Source Identification (SMARA, name of Pit or Job Site): Tidewater Stary Pit
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: Cold Feed Sampling Chute
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
