Sample Record

Owner Labs

  • BSK Associates
  • CT D04 - Hayward DME / District Laboratory

DIME Sample ID 2025-10-27-58

Project Information

Project IdentifiersProject ID: 1000567
DEA: 042K7404
EFIS: 0417000018
DIST-CO-RTE-PM04-MRN-37-R11.2/14.5
Award Date12/20/2024
Closeout DateNot set
Work DescriptionCOLD PLANE AC PVMT, PLACE RHMA AND REPLACE CONCRETE BARRIER.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM IGNACIO OVERHEAD TO PETALUMA RIVER BRIDGE
QA Service Level1 (Verified on 10/16/2024)

Sample Information

Sample Taken Date10/27/2025 Sample Unique Key58
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing01/23/2026
Sample typeProduction Start-Up A brief description of the sample1/2" RHMA-G
The quantity of what the sample constitutes3 Bags Agg From where was the sample collectedManufacturer
First name of sampler or witnessed byJose Leon Last name of sampler or witnessed byAmparan
Title of sampler Telephone number of sampler
Laboratory sample identificationD04-SE-26-002 Linked DIME Sample ID
The fabricator/manufacturer/facility nameVulcan Materials LH (DP) Transportation Laboratory (TL) Number2026-01-20-02
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)91-48-0002
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 collectedConveyer Belt-HMA Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number326129

Submitted Tests

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