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Sample Record for 2023-01-05-11

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

Project Information

Project ID: 66666 DEA: APP EFIS: 0019000052 QA Service Level:
Work Description: Special project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2023-01-05-11
TL Number from the TL Form:
Sample Submitted By Organization: Lynx Cat Mountain Quarry Operations LLC
Sample Organization Contact: (760) 702-6324
Type of Sample: Aggregate Prequalification Program
Type of Material: Aggregate
Sample Taken Date: 01/05/2023
Date that the sample was received by the laboratory/organization performing the testing: 01/06/2023
The quantity of what the sample constitutes: 2 - 5 gallon buckets
A brief description of the sample: Rock Dust
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Lynx Cat Mountain Quarry Operations, LLC.

Material Information

Source Identification (SMARA, name of Pit or Job Site): 91-36-0049
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 @ Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: fine
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:

Test Results