Sample Record for 2022-08-18-96
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993665 DEA: 09386104 EFIS: 0921000035
QA Service Level: 1
DIST-CO-RTE-PM: 09-MNO-395-R25.8/35.3
Work Description: COLD PLANE AC PAVEMENT AND PLACE HMA (TYPE A).
Location Description: MONO COUNTY ABOUT 2 MILES EAST OF MAMMOTH LAKES FROM THE ROUTE 395/203 SEPARATION BRIDGE TO 1.2 MILES NORTH OF GLASS CREEK ROAD
Contractor Name: Qualcon Contractors Inc
Contractor Address: 1645 Esmeralda Ave (PO Box 2889), Minden, NV 89423
Resident Engineer: Rick Moberly Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2022-08-18-96
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Bishop Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 08/18/2022
Date that the sample was received by the laboratory/organization performing the testing: 08/19/2022
The quantity of what the sample constitutes: 1 Bag of Coldfeed
A brief description of the sample: 1/2" Coldfeed
From where was the sample collected: Source
Laboratory sample identification: 2704
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Granite Construction Lee Vining Plant
Material Information
Source Identification (SMARA, name of Pit or Job Site): 99-999-9999
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: Sample device at Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number: 1
Sublot number: 1
Aggregate Mix Number:
Test Results
Test 1 of 1
DIME Test ID: 2022-08-18-96-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D09 - Bishop Field Laboratory
Organization Address: 500 South Main Street,
Organization City: Bishop
Organization State: CA
Organization Zipcode: 93514
Organization Email: chris.talbot@dot.ca.gov
Organization Phone: (760) 872-0794
Data has not been verified.
