Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2025-07-29-61

Project Information

Project IdentifiersProject ID: 209109
DEA: 043G9004
EFIS: 0412000557
COOP: 042513
DIST-CO-RTE-PM04-SON-116,121-46.0/46.7,5.8/R7.4
Award Date07/31/2023
Closeout DateNot set
Work DescriptionMODIFY EXISTING STATE ROUTE 116,121 BONNEAU ROAD INTERSECTION FROM A 4 WAY STOP CONTROLLED INTERSECTION TO A ROUNDABOUT AND SIGNALIZED INTERSECTION.
Location DescriptionSONOMA COUNTY
QA Service Level1 (Verified on 08/15/2022)

Sample Information

Sample Taken Date07/29/2025 Sample Unique Key61
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 testing07/29/2025
Sample typeQuality Assurance A brief description of the samplePCC Agg
The quantity of what the sample constitutes3 Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSuperior Ready Mix 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)91-49-0004
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 collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number590CR2

Submitted Tests

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