Sample Record

DIME Sample ID 2018-03-06-15

Project Information

Project IdentifiersProject ID: 213337
DEA: 024F5404
EFIS: 0213000004
DIST-CO-RTE-PM02-SIS-5-R15.3/R16.5
Award Date07/30/2018
Closeout Date05/23/2022
Work DescriptionBRIDGE REPLACEMENT - SOUTHBOUND ONLY
Location DescriptionSISKIYOU COUNTY NEAR WEED FROM 0.1 MILE SOUTH OF DEETZ ROAD UNDERCROSSING TO 0.6 MILE NORTH OF BLACK BUTTE OVERHEAD 02-0004L
QA Service Level1 (Verified on 11/14/2018)

Owner Lab

  • Sousa Ready Mix, LLC

Sample Information

Sample Taken Date03/06/2018 Sample Unique Key15
Date that the sample was received by the laboratory/organization performing the testing03/06/2018 Sample typeInformational
A brief description of the sample1x#4 Concrete Aggregate The quantity of what the sample constitutes200 lbs
From where was the sample collectedManufacturer First name of sampler or witnessed byGreg
Last name of sampler or witnessed byJuell Title of samplerManaging Member
Telephone number of samplerUnknown Laboratory sample identificationUnknown
Linked DIME Sample IDUnknown The fabricator/manufacturer/facility nameSousa Ready Mix, LLC
Transportation Laboratory (TL) NumberUnknown Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown
Structure unique identifierNot set Structure nameNot set
Bid ItemNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-47-0015
The fabricator's/manufacturer's product name for the sample1 inch Rock The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedUnknown
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set Aggregate Mix NumberNot set
HMA PayNo

Submitted Tests

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