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Sample Record for 2021-10-07-33

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

Project Information

Project ID: 215403 DEA: 021H4004 EFIS: 0216000042 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-R8.3
Work Description: PLACE STRUCTURAL CONCRETE BRIDGE DECK AND BARRIER AND PLACE HMA.
Location Description: SISKIYOU COUNTY NEAR MOUNT SHASTA AT AZALEA ROAD OVERCROSSING
Contractor Name: Abacus Construction, Inc.
Contractor Address: 6850 Haas Road, Anderson, CA 96007
Resident Engineer: Andy O'Sullivan Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-10-07-33
TL Number from the TL Form: 853081
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Acceptance
Type of Material: Aggregate
Sample Taken Date: 10/07/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/09/2021
The quantity of what the sample constitutes: 2 bags for unit weight
A brief description of the sample: Class 2 Aggregate Base
From where was the sample collected: Manufacturer
Laboratory sample identification: D78955
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mountain Gate Quarry

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-45-0001
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: Stockpile
Where the material sample would have been placed if not sampled: 02 SIS 5
Primary Aggregate Nominal Size: 3/4 inch
The concrete mix design number:
Lot number: Unknown
Sublot number: Unknown
Aggregate Mix Number:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2021-10-07-33-1
Test Method: CTM 212-May 2010: Method of Test for Unit Weight of Aggregate
Verified Date: 10/21/2021
Date Tested: 10/11/2021
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
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
Aggregate unit weight 75.98 lbf/ft^3