Sample Record
Owner Lab
- CT D03 - North Region Materials Lab
DIME Sample ID 2020-05-06-40
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214426 DEA: 030A5704 EFIS: 0300020593 |
|---|---|
| DIST-CO-RTE-PM | 03-YUB-20-13.3/R18.2 |
| Award Date | 01/02/2020 |
| Closeout Date | Not set |
| Work Description | Browns Valley Rehab: CONSTRUCT BRIDGE, REALIGN CURVE, WIDEN SHOULDERS AND CULVERT WORK. |
| Location Description | YUBA COUNTY FROM MARYSVILLE ROAD TO THE YUBA RIVER BRIDGE |
| QA Service Level | 1 (Verified on 10/23/2019) |
Sample Information
| Sample Taken Date | 05/06/2020 | Sample Unique Key | 40 |
|---|---|---|---|
| Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 05/06/2020 |
| Sample type | Verification | A brief description of the sample | 3/4 inch HMA w/RAP |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Source |
| First name of sampler or witnessed by | K | Last name of sampler or witnessed by | Mchugh |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichert Hallwood | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA or name of Pit) | 91-58-0006::HALLWOOD PLANT |
|---|---|---|---|
| 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 | Cold Feed | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/4 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | JMF Verification ID | JMF3513-2020-195 |