Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-04-12-6

Project Information

Project IdentifiersProject ID: 212497
DEA: 024E0204
EFIS: 0200020196
DIST-CO-RTE-PM02-SHA-299-77.8/79.7
Award Date02/01/2018
Closeout Date08/14/2019
Work DescriptionPULVERIZE AND RECONSTRUCT PAVEMENT, AND WIDEN WITH AB, HMA, & RHMA
Location DescriptionSHASTA COUNTY NEAR BURNEY FROM 0.2 MILE WEST OF SONOMA STREET TO 0.3 MILE WEST OF ROUTE 89
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date04/12/2018 Sample Unique Key6
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 testing04/13/2018
Sample typeAcceptance A brief description of the sample3/4 cold feed and rap
The quantity of what the sample constitutesJMF4 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byDeryk Last name of sampler or witnessed byCGI
Title of samplerCGI Telephone number of samplerUnknown
Laboratory sample identificationD77324 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameHat Creek - Shaw Pit Facility Transportation Laboratory (TL) NumberT101 C853527
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C853527 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-25-0008::SHAW PIT
The fabricator's/manufacturer's product name for the sampleJMF 3/4 cold feed and rap 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 Size3/4 inch
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set HMA Design ID
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2018-04-12-6-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab04/17/2018Terry McCormick
No
JMF 18-02 3/4 Cold feed. Info
2018-04-12-6-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab04/17/2018Terry McCormick
No
JMF 18-02, Rap extraction grading. Info
2018-04-12-6-3AASHTO T209-12: Standard Method of Test for Theoretical Maximum Specific Gravity (Gmm) and Density of Asphalt Mixtures (Maximum Specific Gravity)Terry McCormickCT D02 - North Region Materials Lab04/18/2018Terry McCormick
No
JMF 18-02, Rap rice. Info