Sample Record
Owner Lab
- CT D01 - Fortuna Field Laboratory
DIME Sample ID 2024-08-05-48
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 1000221 DEA: 010M6804 EFIS: 0123000055 |
|---|---|
| DIST-CO-RTE-PM | 01-HUM-36-6.0/13.4 |
| Award Date | 06/12/2024 |
| Closeout Date | 04/22/2025 |
| Work Description | MICRO-SURFACING, LOW CARBON MICRO-SURFACING, AND DELINEATION. |
| Location Description | HUMBOLDT COUNTY NEAR CARLOTTA FROM 0.2 MILE WEST OF WILDER ROAD TO VAN DUZEN RIVER BRIDGE 04-0094 |
| QA Service Level | 1 (Verified on 04/05/2024) |
Sample Information
| Sample Taken Date | 08/05/2024 | Sample Unique Key | 48 |
|---|---|---|---|
| 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 | 08/05/2024 |
| Sample type | Quality Assurance | A brief description of the sample | Class III Sand |
| The quantity of what the sample constitutes | 1 Day of Paving | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Ben | Last name of sampler or witnessed by | Reeves |
| Title of sampler | ARE | Telephone number of sampler | 7075997930 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Mercer Fraser - Willow Creek | 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) | 91-12-0002 |
|---|---|---|---|
| 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 Jobsite | |
| 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 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-08-05-48-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2024-08-05-48-2 CTM 217-June 2011 (Verified)