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Sample Record for 2022-06-21-48

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

Project Information

Project ID: 993468 DEA: 010C1104 EFIS: 0112000229 QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-60.4
Work Description: Construct New Materials Lab
Location Description: HUMBOLDT COUNTY IN FORTUNA AT THE MATERIALS LABORATORY AT 1050 RIVER RANCH ROAD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: 200 Dinsmore Dr., Fortuna, CA 95502
Resident Engineer: Tai Morgan-Marbet Structure Rep.: Michele Stover

Sample Information

DIME Sample ID: 2022-06-21-48
TL Number from the TL Form:
Sample Submitted By Organization: CT D01 - District 1 Materials Laboratory
Sample Organization Contact: (707) 496-0974
Type of Sample: Preliminary
Type of Material: Aggregate
Sample Taken Date: 06/21/2022
Date that the sample was received by the laboratory/organization performing the testing: 06/22/2022
The quantity of what the sample constitutes: Peliminary data
A brief description of the sample: Coarse PCC Aggregate
From where was the sample collected: Source
Laboratory sample identification: 22-293, 294, 295
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser Fortuna

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-12-0002
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:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: MF CL 2 Salg
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
2022-06-21-48-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates07/06/2022Not scheduledLeif AyresCT D01 - District 1 Materials Laboratory