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Sample Record for 2018-06-30-17

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

Project Information

Project ID: 211669 DEA: 022C0904 EFIS: 0200000161 QA Service Level: 1
DIST-CO-RTE-PM: 02-PLU-70-50.6/51.7
Work Description: BRIDGE WIDENING AND DECK REPLACEMENT, HMA, MGS AND CULVERT REPLACEMENT
Location Description: PLUMAS COUNTY NEAR QUINCY FROM 0.6 MILE WEST TO 0.5 MILE EAST OF SPRING GARDEN BRIDGE OVERHEAD
Contractor Name: MCM Construction
Contractor Address: 6413 32ND STREET, North Highlands, Ca 95660
Resident Engineer: Ronald Collins Structure Rep.: Rothgery, Jeffrey

Sample Information

DIME Sample ID: 2018-06-30-17
TL Number from the TL Form: T101 C990912
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: 06/30/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/02/2018
The quantity of what the sample constitutes: PSE 2 bags
A brief description of the sample: PSE Cold feed and rap
From where was the sample collected: Manufacturer
Laboratory sample identification: D77513
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Dig-It Chester

Material Information

Source Identification (SMARA or name of Pit): Unknown
The fabricator's/manufacturer's product name for the sample: 3/4 cold feed 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: 2018-06-30-17-1
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: 2018-06-30-17-2
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: 2018-06-30-17-3
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.