Sample Record
Owner Lab
- CT HQ - Sacramento Aggregate Testing Laboratory
DIME Sample ID 2021-12-17-44
Project Information
| Project Identifiers | Project ID: 214986 DEA: 041J9704 EFIS: 0414000404 |
|---|---|
| DIST-CO-RTE-PM | 04-SCL-17-2.8/13.94 |
| Award Date | 04/30/2021 |
| Closeout Date | 10/06/2025 |
| Work Description | PAVING WITH RHMA, COLD PLANE AC, AND INSTALL CULVERT. |
| Location Description | SANTA CLARA COUNTY IN AND NEAR LOS GATOS, CAMPBELL AND SAN JOSE FROM HEBARD ROAD TO ROUTE 17/280 SEPARATION |
| QA Service Level | 1 (Verified on 10/19/2020) |
Sample Information
| Sample Taken Date | 12/17/2021 | Sample Unique Key | 44 |
|---|---|---|---|
| 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 testing | 03/21/2022 |
| Sample type | Annual Source Testing | A brief description of the sample | Fine Aggregate |
| The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Source |
| First name of sampler or witnessed by | F. | Last name of sampler or witnessed by | Vega |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | 22-PCCF-0043 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Los Banos TRP | Transportation Laboratory (TL) Number | C570871 |
| 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) | 91-24-0009 |
|---|---|---|---|
| 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 | Los Banos TRP | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-12-17-44-1 CTM 213-December 2012 (Verified)
