Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-05-13-3

Project Information

Project IdentifiersProject ID: 212574
DEA: 02368414
EFIS: 0215000066
DIST-CO-RTE-PM02-SHA-44-R4.6/R6.4
Award Date10/13/2017
Closeout Date11/24/2021
Work DescriptionCONSTRUCT OVERCROSSING, WIDEN WITH HMA AND AB, AND OVERLAY WITH HMA
Location DescriptionSHASTA COUNTY NEAR PALO CEDRO FROM CLOUGH CREEK BRIDGE TO 0.6 MILE WEST OF DESCHUTES ROAD UNDERCROSSING
QA Service Level1 (Verified on 07/28/2017)

Sample Information

Sample Taken Date05/13/2018 Sample Unique Key3
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 testing05/14/2018
Sample typeAcceptance A brief description of the sampleJMF 3 bins
The quantity of what the sample constitutesJMF 8 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byOrtiz
Title of samplerTET Telephone number of samplerUnknown
Laboratory sample identificationD77369 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameTullis Northstate Asphalt Transportation Laboratory (TL) NumberT101 C896275
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C896275 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 sampleJMF 3 bins The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedAt the plant
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1/2 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
2018-05-13-3-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab05/15/2018Terry McCormick
No
JMF, Bin A 5/8. Info
2018-05-13-3-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab05/15/2018Terry McCormick
No
JMF, Bin B 3/8. Info
2018-05-13-3-3AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab05/16/2018Terry McCormick
No
JMF, Bin C Virgin fines. Info