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Sample Record for 2018-06-26-20

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213059 DEA: 023H2204 EFIS: 0217000071 QA Service Level: 1
DIST-CO-RTE-PM: 02-TEH,BUT-32-0.0/2.7,D2.7/D4.7,4.7/5.0
Work Description: PLACE HMA OVERLAY, SHOULDER BACKING, GUARDRAIL & REPLACE AC SURFACING.
Location Description: BUTTE AND TEHAMA COUNTIES FROM BUTTE COUNTY LINE TO 1.6 MILES EAST OF SODA SPRINGS ROAD
Contractor Name: KNIFE RIVER CONSTRUCTION
Contractor Address: 1764 SKYWAY, CHICO, CA 95928
Resident Engineer: Ryan Johnson Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2018-06-26-20
TL Number from the TL Form: T101 C894780
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 06/26/2018
Date that the sample was received by the laboratory/organization performing the testing: 06/26/2018
The quantity of what the sample constitutes: PSE 8 bags
A brief description of the sample: PSE Cold feed and rap
From where was the sample collected: Manufacturer
Laboratory sample identification: D77486
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Knife River, Orland

Material Information

Source Identification (SMARA or name of Pit): unknown
The fabricator's/manufacturer's product name for the sample: 3/4 Cold and Rap
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: At the plant
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number:
Sublot number:

Test Results

Test 1 of 3

DIME Test ID: 2018-06-26-20-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 2 of 3

DIME Test ID: 2018-06-26-20-2
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Test 3 of 3

DIME Test ID: 2018-06-26-20-3
Test Method: AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
Organization City: Redding
Organization State: CA
Organization Zipcode: 96001
Organization Email: ward.jenkins@dot.ca.gov
Organization Phone: (530) 225-3194
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.