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Sample Record for 2021-10-14-39

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: 2021-10-14-39
TL Number from the TL Form: 853084
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: 10/14/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/14/2021
The quantity of what the sample constitutes: Combined Coldfeed and RAP for PSE
A brief description of the sample: Combined 3/4 Inch treated coldfeed and 3/8 Inch RAP
From where was the sample collected: Manufacturer
Laboratory sample identification: D78959
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: J F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA

Material Information

Source Identification (SMARA or name of Pit): 91-45-0017
The fabricator's/manufacturer's product name for the sample: Unknown
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Belt
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

Test Results

Test 1 of 1

DIME Test ID: 2021-10-14-39-1
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.