Sample Record

Owner Lab

  • CT D02 - Redding Northern Regional Laboratory

DIME Sample ID 2017-07-26-16

Project Information

Project IdentifiersProject ID: 211852
DEA: 022H3704
EFIS: 0216000079
DIST-CO-RTE-PM02-SHA-151-0.0/5.5
Award Date01/03/2017
Closeout Date11/29/2017
Work DescriptionASPHALT-RUBBER CHIP SEAL, REPLACE AC SURFACING, STRIPING
Location DescriptionSHASTA COUNTY IN AND NEAR SHASTA LAKE FROM SHASTA DAM TO CORAM UNDERPASS
QA Service Level1 (Verified on 02/15/2017)

Sample Information

Sample Taken Date07/26/2017 Sample Unique Key16
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 testing08/08/2017
Sample typeAcceptance A brief description of the sample9.5mm Chips
The quantity of what the sample constitutes1 bags 40lbs From where was the sample collectedManufacturer
First name of sampler or witnessed byJoe Last name of sampler or witnessed bySturges
Title of samplerPEI Tester Telephone number of samplerUnknown
Laboratory sample identificationD77101 Linked DIME Sample IDD77101
The fabricator/manufacturer/facility nameTullis Northstate Asphalt Transportation Laboratory (TL) NumberT101 C896263
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C896263 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)unknown
The fabricator's/manufacturer's product name for the sample Chips The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedPlant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set Aggregate Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments