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Sample Record for 2019-04-29-26

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

Project Information

Project ID: 213720 DEA: 024H2004 EFIS: 0218000094 QA Service Level: 1
DIST-CO-RTE-PM: 02-SHA-89-26.3/29.2
Work Description: PAVEMENT OVERLAY
Location Description: SHASTA COUNTY ABOUT 10 MILES NORTH OF BURNEY FROM 0.3 MILE NORTH OF CLARK CREEK ROAD TO LAKE BRITTON BRIDGE
Contractor Name: Hat Creek Construction
Contractor Address: 24339 Highway 89 N, Burney, CA 96013
Resident Engineer: TOFAEL ANWAR Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-04-29-26
TL Number from the TL Form: 827788
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 04/29/2019
Date that the sample was received by the laboratory/organization performing the testing: 04/30/2019
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: Untreated Virgin 1/2-inch Type A Aggregate
From where was the sample collected: Source
Laboratory sample identification: D77860F
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Shaw Pit

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-25-0008::SHAW PIT
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: 19-1278.105B
The plant number: Unknown
A detailed description of where the material sample was collected: Lab-Batched from Sized Untreated Aggregate Stockpiles
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number: JMF 19-05-S2
Lot number: 0
Sublot number: 0
Aggregate Mix Number:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2019-04-29-26-1
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 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
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.