Sample Record

Owner Lab

  • CT D01 - Crescent City Field Laboratory

DIME Sample ID 2025-08-18-28

Project Information

Project IdentifiersProject ID: 215620
DEA: 01436404
EFIS: 0100000193
DIST-CO-RTE-PM01-DN-101-35.8/36.5
Award Date07/11/2022
Closeout DateNot set
Work DescriptionDr. Fine Bridge Replacement
Location DescriptionDR. FINE BRIDGE REPLACEMENT FROM LAKE EARL DR TO S FRED D. HAIGHT DR ON HWY 101 ACROSS SMITH RIVER.
QA Service Level1 (Verified on 03/26/2021)

Sample Information

Sample Taken Date08/18/2025 Sample Unique Key28
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 testing08/18/2025
Sample typeQuality Assurance A brief description of the samplecoarse sand, fine sand, 3/8" pea gravel, 3/4" gravel
The quantity of what the sample constitutes4 bags of different aggregate From where was the sample collectedSupplier
First name of sampler or witnessed byGary Last name of sampler or witnessed byZamora
Title of samplerTransportation Engineer Telephone number of sampler7076665469
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameTidewater Bar Plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier01-0020
Structure nameDr fine bridge Bid ItemNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)Tidewater Bar Plant
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 collectedAll samples pulled from stockpiles at Starry Pit
Where the material sample would have been placed if not sampledPier 4 Cap Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberSR-MINOR STRUCTURE NA Lot number
Sublot number Aggregate Mix Number

Submitted Tests

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