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Sample Record for 2021-01-25-3

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

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-01-25-3
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Aggregate
Sample Taken Date: 01/25/2021
Date that the sample was received by the laboratory/organization performing the testing: 01/27/2021
The quantity of what the sample constitutes: 9 bags
A brief description of the sample: Batch Plant - 4 bins - 2 bags each (3/4, 1/2, 3/8, and 1/4) plus 1 bag mineral filler
From where was the sample collected: Supplier
Laboratory sample identification: 21-JFMPP-0007
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Industries

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002
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: Hot Bins
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:

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2021-01-25-3-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)01/27/2021Not scheduledClinton EdmistonCT HQ - Sacramento Aggregate Testing Laboratory