Sample Record for 2015-10-02-6
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 210529 DEA: 060M2604 EFIS: 0612000095
QA Service Level: 1
DIST-CO-RTE-PM: 06-KER-58-R99.2/R99.8
Work Description: REPLACE EASTBOUND SAND CANYON ROAD BRIDGE AND RESURFACE T HE RAMPS.
Location Description: KERN COUNTY NEAR TEHACHAPI FROM SAND CANYON ROAD OVERHEAD TO CACHE CREEK BRIDGE
Contractor Name: KRC Safety Company
Contractor Address: P.O. Box 6356, Visalia, CA 93290
Resident Engineer: Amarjit Dhaliwal Structure Rep.: Eduardo Reyes
Sample Information
DIME Sample ID: 2015-10-02-6
TL Number from the TL Form: c931413
Sample Submitted By Organization: CT HQ - Sacramento Aggregate Testing Laboratory
Sample Organization Contact: (916) 227-7204
Type of Sample: Preliminary
Type of Material: Aggregate
Sample Taken Date: 10/02/2015
Date that the sample was received by the laboratory/organization performing the testing: 11/23/2015
The quantity of what the sample constitutes: 1 bag
A brief description of the sample: Washed Concrete Sand
From where was the sample collected: Fabricator
Laboratory sample identification: 15FPCC-0457
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Holliday Rock Bakersfield
Material Information
Source Identification (SMARA, name of Pit or Job Site): na
The fabricator's/manufacturer's product name for the sample: Holliday Rock Bakersfield Sand
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size:
The concrete mix design number:
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
