Sample Record for 2021-06-10-28
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 214190 DEA: 024G41U4 EFIS: 0218000047
QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS,SIS-5-Var
Work Description: REPLACE REINFORCED CONCRETE BRIDGES & CONSTRUCT RETAINING WALL.
Location Description: SHASTA AND SISKIYOU COUNTIES ABOUT 7 MILES NORTH OF POLLARD FLAT FROM 0.8 MILE SOUTH TO 0.7 MILE NORTH OF SIMS ROAD UNDERCROSSING AND FROM 0.6 MILE SOUTH OF CASTLE CRAGS DRIVE UNDERCROSSING TO 0.2 MILE SOUTH OF SOUTH DUNSMUIR UNDERCROSSING
Contractor Name: J.F. Shea Construction, Inc.
Contractor Address: 17400 Clear Creek Road, Redding, CA 96001
Resident Engineer: Nicole Mallory Structure Rep.: Adam Scardaci
Sample Information
DIME Sample ID: 2021-06-10-28
TL Number from the TL Form: 779375
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 06/10/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/10/2021
The quantity of what the sample constitutes: PSE 2 bags coldfeed at 150 Tons
A brief description of the sample: Coldfeed Lime Treated 3/4" Agg
From where was the sample collected: Manufacturer
Laboratory sample identification: D78839
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: J F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA
Material Information
Source Identification (SMARA or name of Pit): 91-45-0017
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: Samplimg Device at Plant
Where the material sample would have been placed if not sampled: 02 SHA SIS 5
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number: Unknown
Lot number: Unknown
Sublot number: Unknown
Test Results
Test 1 of 1
DIME Test ID: 2021-06-10-28-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D02 - North Region Materials Lab
Organization Address: 1657 Riverside Dr,MS-83
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.
Tests Assigned to this Sample
| DIME Test ID | Test Method | Assigned Date | Test Date | Assigned By | Assigned Lab | Test Comments | Assigned To |
| No tests have been assigned to this sample. |