Sample Record
Owner Lab
- Jaxon Enterprises - Deer Creek Rock & Asphalt
DIME Sample ID 2022-09-16-42
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 66666 DEA: APP EFIS: 0019000052 |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 09/16/2022 | Sample Unique Key | 42 |
|---|---|---|---|
| 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 | 09/21/2022 |
| Sample type | Aggregate Prequalification Program | A brief description of the sample | 1" x #4 |
| The quantity of what the sample constitutes | 4 buckets | From where was the sample collected | Source |
| First name of sampler or witnessed by | Jordan | Last name of sampler or witnessed by | Baker |
| Title of sampler | QC manager | Telephone number of sampler | 5302270982 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Deer Creek Rock and Asphalt | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-54-0021 |
|---|---|---|---|
| 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 | Stockpile at Plant | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||