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

Sample Record for 2019-01-10-2


Project Information

Project ID: 212408 DEA: 09350804 EFIS: 0900020055 QA Service Level: 1
DIST-CO-RTE-PM: 09-MNO-395-80.6/84.1
Work Description: CONSTRUCT PULVERIZED ROADBED, HMA AND ANCHORED WIRE MESH SYSTEM.
Location Description: MONO COUNTY NEAR BRIDGEPORT FROM BUCKEYE ROAD TO 2.9 MILES SOUTH OF SWAUGER CANYON ROAD
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC. Contractor Address: PO BOX 2210
Resident Engineer: Lee Scotese Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-01-10-2
TL Number from the TL Form:
Sample Submitted By Organization: CT D09 - Field Laboratory
Sample Organization Contact: (760) 872-5211
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 01/10/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: AM
A brief description of the sample: 1 Bag
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 2
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: Best Rock Borrow Pit
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number:
Sublot number: