Sample Record

Owner Lab

  • CT QASI - Los Angeles Field Laboratory

DIME Sample ID 2017-11-09-12

Project Information

Project IdentifiersProject ID: 9999
DEA: 00000000
EFIS: 0000000000
COOP: 99999333399
MINOR: 333333
Permit Numbers: 555555 0400NRT0000
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level1 (Verified on 04/05/2013)

Sample Information

Sample Taken Date11/09/2017 Sample Unique Key12
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeQuality Control A brief description of the sample1/2 Aggregate
The quantity of what the sample constitutes1 ton of asphalt From where was the sample collectedSource
First name of sampler or witnessed byJeff Last name of sampler or witnessed bySulka
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameGranite Rock Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)SMARA No. 91-36-0146
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 collectedBelt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID JMF3512-2017-2

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.