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Sample Record for 2022-06-03-23

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

Project Information

Project ID: 993182 DEA: 024F5204 EFIS: 0213000002 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS-5-R9.9/R68.1
Work Description: ROADWAY EX, HYDRAULIC BIOTIC GROWTH MED. AND MIDWEST GUARDRAIL SYSTEM.
Location Description: SISKIYOU COUNTY AT VARIOUS LOCATIONS FROM 0.2 MILE NORTH OF REAM AVENUE OVERCROSSING TO 0.2 MILE SOUTH OF HILT ROAD OVERCROSSING
Contractor Name: Meyers Earthwork Inc
Contractor Address: Box 493730, Redding, CA 96049
Resident Engineer: Nicole Mallory Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2022-06-03-23
TL Number from the TL Form: 891176
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: 06/03/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/06/2022
The quantity of what the sample constitutes: Project
A brief description of the sample: 2 bags of Shoulder Backing
From where was the sample collected: Job Site
Laboratory sample identification: D79043
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Meyer's Earthwork - Custom Crushing

Material Information

Source Identification (SMARA, name of Pit or Job Site): custom crushing
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: Shoulder Backing Machine
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1-1/2 inch
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test results on following page(s): 1

Test Results

Test 1 of 1

DIME Test ID: 2022-06-03-23-1
Test Method: CTM 212-May 2010: Method of Test for Unit Weight of Aggregate
Verified Date: 06/16/2022
Date Tested: 06/10/2022
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: does not comply
Additional Comments When Verified:
Aggregate unit weight 102.01 lbf/ft^3