Sample Record for 2021-11-17-29
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 215348 DEA: 060U4204 EFIS: 0616000004
QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-99-R4.9/11.6
Work Description: CONSTRUCT CRCP, PLACE HMA, AND ROADWAY EXCAVATION.
Location Description: FRESNO COUNTY IN AND NEAR SELMA AND FOWLER FROM MCCALL AVENUE UNDERCROSSING TO 0.5 MILE NORTH OF MERCED STREET UNDERCROSSING
Contractor Name: SECURITY PAVING COMPANY, INC.
Contractor Address: 3075 Townsgate Rd. Suite 200, Westlake Village CA 91361
Resident Engineer: Chris Wilfong Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2021-11-17-29
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: Dispute Resolution
Type of Material: Aggregate
Sample Taken Date: 11/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/23/2021
The quantity of what the sample constitutes: 2 Bags Agg., 1 Bag Rap
A brief description of the sample: 3/4" HMA-A-SP R15
From where was the sample collected: Manufacturer
Laboratory sample identification: 0666A-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan Ashlan
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-10-0014::ROCKFIELD PLANT
The fabricator's/manufacturer's product name for the sample:
The fabricator/manufacturer designation for the sample:
The plant number: 220817
A detailed description of where the material sample was collected: Belt Cut at Vulcan Ashlan
Where the material sample would have been placed if not sampled: Asphalt Paving
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| 2021-11-17-29-1 | AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis) | 12/24/2021 | Not scheduled | Satish Jain | CT D08 - Fontana Southern Regional Laboratory | | |
| 2021-11-17-29-2 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 12/24/2021 | Not scheduled | Satish Jain | CT D08 - Fontana Southern Regional Laboratory | | |
| 2021-11-17-29-3 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | 12/24/2021 | Not scheduled | Satish Jain | CT D08 - Fontana Southern Regional Laboratory | | |
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