Sample Record for 2018-01-01-18
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: 2018-01-01-18
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: 01/01/2018
Date that the sample was received by the laboratory/organization performing the testing: 02/02/2018
The quantity of what the sample constitutes: 3 bags
A brief description of the sample: Brief description of sample
From where was the sample collected: Source
Laboratory sample identification: SID1234
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Source Name
Material Information
Source Identification (SMARA, name of Pit or Job Site): Smara 1234
The fabricator's/manufacturer's product name for the sample: Product Name
The fabricator/manufacturer designation for the sample: Designation
The plant number: Plant1234
A detailed description of where the material sample was collected: Plant Stockpile
Where the material sample would have been placed if not sampled: Southwest footing of the Lone Tree Canal abut
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: Mix1234
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
Test 1 of 4
DIME Test ID: 2018-01-01-18-1
Test Method: ASTM C136-06: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
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.
Test 2 of 4
DIME Test ID: 2018-01-01-18-2
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
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.
Test 3 of 4
DIME Test ID: 2018-01-01-18-3
Test Method: ASTM C117-13: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
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.
Test 4 of 4
DIME Test ID: 2018-01-01-18-4
Test Method: ASTM C566-13: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
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.
