Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-05-31-14

Project Information

Project IdentifiersProject ID: 212784
DEA: 023H1504
EFIS: 0217000064
DIST-CO-RTE-PM02-LAS-299-0.0/4.7
Award Date11/30/2017
Closeout Date01/08/2019
Work DescriptionAC OVERLAY, REPLACE ASPHALT CONCRETE SURFACING AND GUARDRAIL.
Location DescriptionLASSEN COUNTY NEAR MCARTHUR FROM SHASTA COUNTY LINE TO 4.0 MILES WEST OF MUCK VALLEY HYDRO ROAD.
QA Service Level1 (Verified on 05/03/2018)

Sample Information

Sample Taken Date05/31/2018 Sample Unique Key14
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 testing05/31/2018
Sample typeAcceptance A brief description of the samplePSE 2, 3/4 Cold feded and Rap
The quantity of what the sample constitutesPSE 3 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byDerrick Last name of sampler or witnessed byAndy
Title of samplerCGI Telephone number of samplerUnknown
Laboratory sample identificationD77434 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameJF Shea Fawndale Transportation Laboratory (TL) NumberT101 C736683
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C736683 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 sample3/4 Cold feed and rap 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 Size3/4 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
2018-05-31-14-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/04/2018Terry McCormick
No
PSE, 3/4 Cold feed. Info
2018-05-31-14-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/05/2018Terry McCormick
No
PSE, rap extraction grading. Info
2018-05-31-14-3AASHTO 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 Lab06/06/2018Terry McCormick
No
PSE #2, Rap rice. Info