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Sample Record for 2021-06-02-40

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

Project Information

Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-3-38.0/38.6
Work Description: BRIDGE REPLACEMENT
Location Description: SISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
Contractor Name: Steelhead Constructors
Contractor Address: 2940 INNSBRUCK DRIVE, REDDING CA 96003
Resident Engineer: Nicole Mallory Structure Rep.: Andy O'Sullivan

Sample Information

DIME Sample ID: 2021-06-02-40
TL Number from the TL Form:
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 06/02/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/02/2021
The quantity of what the sample constitutes: JMF
A brief description of the sample: 3/8 inch lime treated aggregate
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Tullis Inc Shasta Ranch Agg Anderson Ca

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-45-0057
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: Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Test 1 of 1

DIME Test ID: 2021-06-02-40-1
Test Method: AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)
Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Organization Address: 1657 Riverside Drive,
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.