Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 10016 DEA: 06342524 EFIS: 0600000381
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-180-R71.8/74.5
Work Description: NEW EXPRESS HIGHWAY
Location Description: FRESNO COUNTY ABOUT 6.3 MILES EAST OF FRESNO FROM 0.6 MILE WEST OF QUALITY AVENUE TO 0.2 MILE WEST OF SMITH AVENUE
Contractor Name: American Paving Co
Contractor Address: 315 North Thorne Avenue, Fresno, CA 93706
Resident Engineer: Mark Mengoni Structure Rep.: Mike Bloom
DIME Sample ID: 2014-09-10-4
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: 09/10/2014
Date that the sample was received by the laboratory/organization performing the testing: 09/10/2014
The quantity of what the sample constitutes: 3 bags
A brief description of the sample: 1x4
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Builders Concrete Ready Mix Plant Sanger
Source Identification (SMARA, name of Pit or Job Site): 2014-09-10-001
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: conveyor belt
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
DIME Test ID: 2014-09-10-4-1
Test Method: ASTM C136-06: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
Data has not been verified.
DIME Test ID: 2014-09-10-4-2
Test Method: AASHTO T255-0: Standard Method of Test for Total Evaporable Moisture Content of Aggregate by Drying
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
Data has not been verified.
DIME Test ID: 2014-09-10-4-3
Test Method: ASTM C117-04: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
Data has not been verified.
