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Sample Record for 2021-06-17-35

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

Project Information

Project ID: 212777 DEA: 021H1104 EFIS: 0215000106 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS-299-25.58/25.58
Work Description: BUILDING WORK.
Location Description: LASSEN COUNTY ABOUT 11 MILES EAST OF BIEBER AT THE ADIN MAINTENANCE STATION
Contractor Name: Walsh Construction Company II, LLC (Walsh)
Contractor Address: 1390 Willow Pass Road Suite 950, Concord, CA 94520
Resident Engineer: Mike Zdenek Structure Rep.: Chris Brace

Sample Information

DIME Sample ID: 2021-06-17-35
TL Number from the TL Form: 766443
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: 06/17/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/21/2021
The quantity of what the sample constitutes: 1 bag at 91.19 Tons
A brief description of the sample: 3/8 Inch hot bin sample for PSE
From where was the sample collected: Manufacturer
Laboratory sample identification: D78847
Structure unique identifier:
Structure name: Not Applicable
The fabricator/manufacturer/facility name: Eagle Peak, Alturas, Ca

Material Information

Source Identification (SMARA or name of Pit): Eagle Peak
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unk
A detailed description of where the material sample was collected: Batch Plant Hot Bins
Where the material sample would have been placed if not sampled: 02 LAS 299 PM 25 6
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: Not Applicable
Lot number: Unknown
Sublot number: Unknown

Test Results

Test 1 of 1

DIME Test ID: 2021-06-17-35-1
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 IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.