Sample Record
Owner Labs
- BSK Associates
- CT D04 - Hayward DME / District Laboratory
DIME Sample ID 2021-08-20-59
Project Information
| Project Identifiers | Project ID: 214114 DEA: 040A5394 EFIS: 0418000244 |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80,12-11.4/12.8, 2.1/2.8 |
| Award Date | Not set |
| Closeout Date | 02/24/2023 |
| Work Description | Widen EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc. |
| Location Description | I-80/I-680/Route 12 Interchange |
| QA Service Level | 1 (Verified on 04/23/2019) |
Sample Information
| Sample Taken Date | 08/20/2021 | Sample Unique Key | 59 |
|---|---|---|---|
| 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 testing | 08/20/2021 |
| Sample type | Verification | A brief description of the sample | 4 Bags of Mixed Aggregate |
| The quantity of what the sample constitutes | 4 Bags | From where was the sample collected | Fabricator |
| First name of sampler or witnessed by | Nick | Last name of sampler or witnessed by | Hall |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Syar Vallejo | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name | Bid Item | Not set |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-48-0002::LAKE HERMAN QUARRY |
|---|---|---|---|
| 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 collected | Plant QC | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/4 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-81 | Date Created | 10/06/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-318-2021-99 | JMF Status | Submittal Accepted for Verification |
| Producer Mix ID | 411101510-LD_0221 | Authorized Date | N/A |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-08-20-59-1 AASHTO T27-14 (Verified)
DIME Test ID: 2021-08-20-59-2 AASHTO T84-14 (Verified)
DIME Test ID: 2021-08-20-59-3 AASHTO T85-13 (Verified)
DIME Test ID: 2021-08-20-59-4 AASHTO T96-02r10 (Verified)
DIME Test ID: 2021-08-20-59-5 AASHTO T176-08 (Verified)
DIME Test ID: 2021-08-20-59-6 AASHTO T209-12 (Verified)
DIME Test ID: 2021-08-20-59-7 AASHTO T304-11 (Verified)
