Sample Record for 2019-05-29-15
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 213323 DEA: 081G4604 EFIS: 0816000005
QA Service Level: 1
DIST-CO-RTE-PM: 08-SBD-15-174.0/175.0
Work Description: COLD PLANE AND OVERLAY W/OGFC
Location Description: SAN BERNARDINO COUNTY FROM 2.5 MILES SOUTH OF BAILEY ROAD OVERCROSSING TO 1.2 MILES SOUTH OF NIPTON ROAD OVERCROSSING
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 38000 Monroe St, Indio, CA 92203
Resident Engineer: Darcy Davis Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2019-05-29-15
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 05/29/2019
Date that the sample was received by the laboratory/organization performing the testing: 05/31/2019
The quantity of what the sample constitutes: PSE 10 Bags
A brief description of the sample: 1/2 HMA-OGFC-SP
From where was the sample collected: Manufacturer
Laboratory sample identification: 0314G-19
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Aggregate Industries Sloan Quarry Nevada
Material Information
Source Identification (SMARA, name of Pit or Job Site): Aggregate Industries Sloan Quarry
The fabricator's/manufacturer's product name for the sample: 1/2 HMA-OGFC-SP
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Belt Cut at Plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test Results
