Sample Record for 2020-04-28-15
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214589 DEA: 020J1604
QA Service Level: 1
DIST-CO-RTE-PM: 02-PLU-284-0.0/8.3
Work Description: PLACE HMA (TYPE A), PRECOATED AGGREGATE (SEAL COAT), HMA (LEVELING).
Location Description: PLUMAS COUNTY NEAR CHILCOOT FROM ROUTE 70 TO 1 MILE NORTH OF LITTLE LAST CHANCE CREEK BRIDGE NUMBER 09-0072
Contractor Name: HAT CREEK CONSTRUCTION & MATERIALS, INC.
Contractor Address: 24339 STATE HIGHWAY 89 N.;, BURNEY CA 96013
Resident Engineer: Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2020-04-28-15
TL Number from the TL Form: 733187
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: 04/28/2020
Date that the sample was received by the laboratory/organization performing the testing: 04/29/2020
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 3/4-inch Type A Treated Virgin Aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification: D78415
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Ward Lake Plant, Litchfield, CA
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-18-0008
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Cold Feed
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: JMF 20-03-S2
Lot number: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test Results
