Sample Record for 2019-01-29-16
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125
QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-5-R3.8/R11.7
Work Description: WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location Description: SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
Contractor Name: J.F. SHEA CONSTRUCTION
Contractor Address: P.O. BOX 494519, REDDING, CA 96049-4519
Resident Engineer: Henry Benner Structure Rep.: Eric Chaffee
Sample Information
DIME Sample ID: 2019-01-29-16
TL Number from the TL Form: 001576
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 01/29/2019
Date that the sample was received by the laboratory/organization performing the testing: 03/29/2019
The quantity of what the sample constitutes: JMF
A brief description of the sample: 1/2-inch Untreated Aggregate
From where was the sample collected: Source
Laboratory sample identification: D77809A
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fawndale Rock Quarry
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-45-0017::FAWNDALE ROCK QUARRY
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Untreated Stockpile
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: JMF 19-03-S1
Lot number: 0
Sublot number: 0
Aggregate Mix Number:
Test Results
