Sample Record for 2014-09-04-8
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 209065 DEA: 050G0704 EFIS: 0500000055
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-22.3/23.0
Work Description: UPGRADE DRAINAGE CULVERTS
Location Description: SANTA BARBARA COUNTY IN GOLETA FROM 0.2 MILE EAST TO 0.7 MILE WEST OF FAIRVIEW AVENUE OVERCROSSING
Contractor Name: Flatiron
Contractor Address: 1770 LA COSTA MEADOWS DRIVE, SAN MARCOS CA 92078
Resident Engineer: Michael Mortensen Structure Rep.: Ray Barajas
Sample Information
DIME Sample ID: 2014-09-04-8
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Annual Source Testing
Type of Material: Aggregate
Sample Taken Date: 09/04/2014
Date that the sample was received by the laboratory/organization performing the testing: 09/04/2014
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Inch and Half X four
From where was the sample collected: Source
Laboratory sample identification: 14CPCC-0296 C760326
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vulcan
Material Information
Source Identification (SMARA, name of Pit or Job Site): 91-19-0019::BOULEVARD
The fabricator's/manufacturer's product name for the sample: Santa Barbara
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Belt C
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
