Sample Record

Owner Lab

  • CT D09 - Bishop Field Laboratory

DIME Sample ID 2024-05-07-6

Project Information

Project IdentifiersProject ID: 995257
DEA: 09401004
EFIS: 0924000007
DIST-CO-RTE-PM09-INY-190-9.8-68.0
Award DateNot set
Closeout DateNot set
Work DescriptionEmergency Repair from Flood Damage to State Route 190 near Olancha, CA.
Location DescriptionState Route 190
QA Service Level1 (Verified on 10/19/2023)

Sample Information

Sample Taken Date05/07/2024 Sample Unique Key6
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 testing05/07/2024
Sample typeDepartment Acceptance A brief description of the sample3/4" HMA Post {Plant Gradation
The quantity of what the sample constitutesI Box of HMA From where was the sample collectedJob Site
First name of sampler or witnessed byDerek Last name of sampler or witnessed byCarrington
Title of samplerMREA Telephone number of sampler7609208313
Laboratory sample identification3886 Linked DIME Sample IDHMA-02 Grad
The fabricator/manufacturer/facility nameGranite 5 Bridges Bishop Plant Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)00-00-0000
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 collectedWindrow at Job Site
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 Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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