Sample Record

Owner Lab

  • CT D06 - Millbrook Field Laboratory

DIME Sample ID 2023-05-08-98

Project Information

Project IdentifiersProject ID: 993804
DEA: 043J0624
EFIS: 0419000534
DIST-CO-RTE-PM04-SM-101-16.5/23.0
Award Date08/24/2022
Closeout Date04/10/2024
Work DescriptionCOLD PLANE AND PLACE HMA, REPLACE GUARDRAIL AND CURB RAMPS.
Location DescriptionSAN MATEO COUNTY AT VARIOUS LOCATION FROM BROADWAY OVERCROSSING TO 0.2 MILE NORTH OF OYSTER POINT BOULEVARD OVERCROSSING
QA Service Level1 (Verified on 05/19/2022)

Sample Information

Sample Taken Date05/08/2023 Sample Unique Key98
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 testing05/08/2023
Sample typeAcceptance A brief description of the sample1X#4 & 3/8 Coarse Agg
The quantity of what the sample constitutes0 From where was the sample collectedManufacturer
First name of sampler or witnessed byFrank Last name of sampler or witnessed byAlas-Arteaga
Title of sampler Telephone number of sampler2092250104
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJJJ Redi-Mix 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 collectedJobsite Stockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberHE4X4BM Lot number
Sublot number Aggregate Mix Number

Submitted Tests

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