Sample Record for 2019-10-14-35
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214136 DEA: 010F3604 EFIS: 0115000115
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-R39.2/R48.3
Work Description: COLD PLANE AC PAVEMENT, RHMA OVERLAY, AND GUARDRAIL INSTALLATION.
Location Description: HUMBOLDT COUNTY NEAR REDCREST, PEPPERWOOD, AND STAFFORD FROM ENGLWOOD PARK UNDERCROSSING TO EEL RIVER BRIDGE AND OVERHEAD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: PO BOX 1006, EUREKA CA 95502
Resident Engineer: Joaquin Rodriguez Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2019-10-14-35
TL Number from the TL Form:
Sample Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Sample Organization Contact: (559) 292-2188
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 10/14/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/16/2019
The quantity of what the sample constitutes: JMF 3 bags
A brief description of the sample: coarse aggregate
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Fortuna
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-12-0002::SANDY PRAIRIE
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: Unknown
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: 1
Sublot number: 1
Aggregate Mix Number:
Test Results
