Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 994087 DEA: 051G4104 EFIS: 0515000012
QA Service Level: 1
DIST-CO-RTE-PM: 05-SB-101-4.0/4.8
Work Description: Santa Claus Lane Bike Path - !!Charge time to 05-0N72U4 per Project Manager / Corridor Manager!!
Location Description: !!Charge time to 05-0N72U4 per Project Manager / Corridor Manager!!
Contractor Name: GRANITE CONSTRUCTION COMPANY
Contractor Address: 5335 Debbie Road, Santa Barbara, CA 93111
Resident Engineer: Luobao Cai Structure Rep.: Josh Madrigal
DIME Sample ID: 2023-03-06-11
TL Number from the TL Form:
Sample Submitted By Organization: CT D05 - Carpinteria Field Laboratory
Sample Organization Contact: (805) 621-3616
Type of Sample: Department Acceptance
Type of Material: Aggregate
Sample Taken Date: 03/06/2023
Date that the sample was received by the laboratory/organization performing the testing: 03/06/2023
The quantity of what the sample constitutes: production stockpile.
A brief description of the sample: 3/8 to #8 aggregate
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Martin Marrieta Goleta
Source Identification (SMARA, name of Pit or Job Site): 91-42-0003
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: Martin Marietta Goleta
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 3/8 inch
The concrete mix design number: 725A1Z0P
Lot number:
Sublot number:
Aggregate Mix Number:
