Sample Record

DIME Sample ID 2021-04-21-28

Project Information

Project IdentifiersProject ID: 215062
DEA: 030F2904
EFIS: 0314000101
DIST-CO-RTE-PM03-BUT-99-14.9/15.7
Award Date09/24/2020
Closeout Date03/02/2022
Work DescriptionCONSTRUCT BRIDGE AND ROADWAY; & REMOVE BRIDGE.
Location DescriptionBUTTE COUNTY ABOUT 10 MILES NORTH OF GRIDLEY FROM 0.3 MILE SOUTH TO 0.5 MILE NORTH OF NELSON AVENUE
QA Service Level1 (Verified on 07/20/2020)

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

Sample Information

Sample Taken Date04/21/2021 Sample Unique Key28
Date that the sample was received by the laboratory/organization performing the testing04/01/2021 Sample typeVerification
A brief description of the sample3/4" (Nominal Size) Untreated Virgin Aggregate The quantity of what the sample constitutesJMF Verification
From where was the sample collectedManufacturer First name of sampler or witnessed byTeichert Personnel (SAMPLER)
Last name of sampler or witnessed by Brad McKeehan (WITNESS) Title of sampler
Telephone number of sampler Laboratory sample identification
Linked DIME Sample IDJMF21-020B The fabricator/manufacturer/facility nameTeichert - Hallwood Plant
Transportation Laboratory (TL) NumberC706327 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)91-58-0006::HALLWOOD 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 collectedCold Feed
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix NumberNot set

JMF Information

Verification IDJMF3513-2021-55 Date Created06/01/2021
JMF Submittal IDJMF3511-23-2021-68 JMF StatusSubmittal Authorized For Use
Producer Mix ID309-40432407-V Authorized Date09/10/2021

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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