Sample Record

Owner Lab

  • CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2018-01-08-13

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 211875
DEA: 040J6404
EFIS: 0414000021
DIST-CO-RTE-PM04-SON-101-29.3/R43.4
Award Date03/03/2017
Closeout Date06/21/2019
Work DescriptionRESURFACE AND RESTORE PAVEMENT FOR MAINLINE AND RAMPS
Location DescriptionSONOMA COUNTY IN AND NEAR WINDSOR AND HEALDSBURG FROM WINDSOR LANE UNDERCROSSING TO ROUTE 101/128 SEPARATION
QA Service Level1 (Verified on 04/18/2017)

Sample Information

Sample Taken Date01/08/2018 Sample Unique Key13
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 testing04/23/2018
Sample typeAnnual Source Testing A brief description of the sampleFine PCC Aggregate
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byJ Last name of sampler or witnessed byNixa
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identification18-0084 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSyar Healdsburg Transportation Laboratory (TL) NumberC874188
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)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 Quarry
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 Aggregate Mix NumberNot set
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2018-01-08-13-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandPhillip Montes, CT HQ - Sacramento Aggregate Testing Laboratory05/29/2018Phillip Montes
Yes
05/29/2018

Sample File Attachments

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Test File Attachments


DIME Test ID: 2018-01-08-13-1 CTM 213-December 2012 (Verified)