Sample Record

Owner Lab

  • CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2016-11-07-12

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 209060
DEA: 041A2904
EFIS: 0400000482
DIST-CO-RTE-PM04-SON-12-9.6
Award Date03/11/2014
Closeout Date01/10/2019
Work DescriptionREPLACE BRIDGE AND WIDEN APPROACHES.
Location DescriptionSONOMA COUNTY NEAR THE CITY OF SEBASTOPOL AT LAGUNA DE SANTA ROSA BRIDGE
QA Service Level1 (Verified on 01/23/2014)

Sample Information

Sample Taken Date11/07/2016 Sample Unique Key12
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 testing03/03/2017
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes5 bags From where was the sample collectedSource
First name of sampler or witnessed byPlant Last name of sampler or witnessed byPersonnel
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identification17CPCC-0139 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSyar Healdsburg Transportation Laboratory (TL) NumberC918644
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-49-0062::HEALDSBURG TERRACE PHASE VI
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpile @ Plant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Sizefine
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2016-11-07-12-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandPhillip MontesCT HQ - Sacramento Aggregate Testing Laboratory06/22/2017Phillip Montes
Yes
06/22/2017