Sample Record for 2023-11-14-77
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 994321 DEA: 040K1604 EFIS: 0416000044
QA Service Level: 1
DIST-CO-RTE-PM: 04-ALA,CC-80-R7.6/8.0,0.0/13.5
Work Description: CONSTRUCT RHMA, LIGHTING SYSTEM, AND CONCRETE BARRIER.
Location Description: ALAMEDA AND CONTRA COSTA COUNTIES IN ALBANY AND CROCKETT FROM 0.4 MILE SOUTH OF ALAMEDA COUNTY LINE TO 0.2 MILE SOUTH OF POMONA STREET
Contractor Name: Bay Cities Paving & Grading (Jeff Brandt)
Contractor Address: 1450 CIVIC CT, BLDG B #400, CONCORD, CA 94520
Resident Engineer: Wesley Morrison Structure Rep.: William Sommer
Sample Information
DIME Sample ID: 2023-11-14-77
TL Number from the TL Form:
Sample Submitted By Organization: CT D04 - Richmond Field Laboratory
Sample Organization Contact: (510) 231-7151
Type of Sample: Quality Assurance
Type of Material: Aggregate
Sample Taken Date: 11/14/2023
Date that the sample was received by the laboratory/organization performing the testing: 12/20/2023
The quantity of what the sample constitutes: Sample 1 of the day
A brief description of the sample: 1 x 4 INCH PCC and Sand
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Vanguard San Pablo Dam Plant
Material Information
Source Identification (SMARA, name of Pit or Job Site): NONE
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: Sample Pick-Up @ Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: 550MAC
Lot number:
Sublot number:
Aggregate Mix Number:
Test Results
