Sample Record for 2021-09-20-43
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 212252 DEA: 033F5604 EFIS: 0313000033
QA Service Level: 1
DIST-CO-RTE-PM: 03-SUT,YUB-20-17.0/17.1,0.0/0.4
Work Description: INSTALL CAST-IN-STEEL SHELL CONCRETE PILE.
Location Description: SUTTER AND YUBA COUNTIES IN YUBA CITY AND MARYSVILLE AT THE FEATHER RIVER BRIDGE AND OVERHEAD
Contractor Name: CALIFORNIA ENGINEERING CONTRACTORS, INC.
Contractor Address: 20 HAPPY VALLEY ROAD, PLEASANTON CA 94566
Resident Engineer: Selvendran Manoharan Structure Rep.: Brent Bullard
Sample Information
DIME Sample ID: 2021-09-20-43
TL Number from the TL Form: na
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Per Request
Type of Material: Aggregate
Sample Taken Date: 09/20/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/04/2021
The quantity of what the sample constitutes: 1-5 gallon bucket
A brief description of the sample: 1x4 coarse aggregate
From where was the sample collected: Job Site
Laboratory sample identification: 21-PCCC-168
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Field
Material Information
Source Identification (SMARA, name of Pit or Job Site): not provided
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: field
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
