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Sample Record for 2020-05-07-3

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

Project Information

Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_First SR_Last

Sample Information

DIME Sample ID: 2020-05-07-3
TL Number from the TL Form:
Sample Submitted By Organization: Stonemont Solutions, Incorporated
Sample Organization Contact: (970) 674-1148
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 05/07/2020
Date that the sample was received by the laboratory/organization performing the testing: 05/07/2020
The quantity of what the sample constitutes: 1000
A brief description of the sample: man sand
From where was the sample collected: Other
Laboratory sample identification: 21452098
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Stonemont

Material Information

Source Identification (SMARA, name of Pit or Job Site): Smara 1234
The fabricator's/manufacturer's product name for the sample: Man Sand
The fabricator/manufacturer designation for the sample: Sample
The plant number: 306
A detailed description of where the material sample was collected: plant
Where the material sample would have been placed if not sampled: Southwest footing of the Lone Tree Canal abut
Primary Aggregate Nominal Size: 1/4 inch
The concrete mix design number: G3-15-STR-006F
Lot number: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2020-05-07-3-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: Stonemont Solutions, Incorporated
Organization Address: 128 North 6th Street, Suite A,
Organization City: Windsor
Organization State: CO
Organization Zipcode: 80550
Organization Email: jbeal@stonemont.com
Organization Phone: (970) 674-1148
Data has not been verified.