Sample Record for 2024-07-16-99
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 993184 DEA: 040A7724 EFIS: 0420000288 COOP: 0422825
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA-80-6.4/6.8
Work Description: Excavation, HMA, structural concrete, minor concrete and drainage.
Location Description: IN BERKELEY AND ALBANY FROM 0.6 MILE NORTH OF UNIVERSITY AVENUE OVERCROSSING TO 0.3 MILE SOUTH OF EL CERRITO SEPARATION AND OVERHEAD
Contractor Name: OC Jones (Will Dieterich)
Contractor Address: 1520 Fourth Street, Berkeley, CA 94710
Resident Engineer: Gary Tsigelman Structure Rep.: Eric Urementa
Sample Information
DIME Sample ID: 2024-07-16-99
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 07/16/2024
Date that the sample was received by the laboratory/organization performing the testing: 07/16/2024
The quantity of what the sample constitutes: 3 bags
A brief description of the sample: 3/8 PCC +Sands-Orca+Elliot
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Central Plant -Oakland
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-01-0009
The fabricator's/manufacturer's product name for the sample: 3/8" PCC Mix
The fabricator/manufacturer designation for the sample:
The plant number:
A detailed description of where the material sample was collected: Plant Stockpiles
Where the material sample would have been placed if not sampled: Curtain wall for under pass
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: DDJ118K3
Lot number:
Sublot number:
Aggregate Mix Number: DDJ118K3
Test Results
