Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2025-05-13-45

Project Information

Project IdentifiersProject ID: 1001165
DEA: 061H6304
EFIS: 0625000097
DIST-CO-RTE-PM06-FRE-6-43.95
Award Date02/03/2025
Closeout Date07/11/2025
Work DescriptionThe scope of work will include culvert replacement, pavement repair, traffic control, and pavement delineation.
Location DescriptionFresno County, Rout I-5 at PM 43.95.
QA Service Level1 (Verified on 04/11/2025)

Sample Information

Sample Taken Date05/13/2025 Sample Unique Key45
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing05/13/2025
Sample typeAcceptance A brief description of the sample3/4 HMA coldfeed
The quantity of what the sample constitutes29 tons From where was the sample collectedManufacturer
First name of sampler or witnessed byJonathon Last name of sampler or witnessed byChaney
Title of samplerTET Telephone number of sampler5592309471
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameGranite Coalinga Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-10-0005
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 collectedColdfeed Chute
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number1
Sublot number10 Aggregate Mix Number

Submitted Tests

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