Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-06-11-9

Project Information

Project IdentifiersProject ID: 212845
DEA: 023H1304
DIST-CO-RTE-PM02-LAS-395-47.0/56.5
Award Date12/22/2017
Closeout Date01/09/2019
Work DescriptionAC OVERLAY, REPLACE AC SURFACE, RUMBLE STRIP, GUARDRAIL
Location DescriptionLASSEN COUNTY AT AND NEAR JANESVILLE FROM 1.9 MILES SOUTH OF LAKECREST DRIVE TO 0.2 MILE NORTH OF SUNNYSIDE ROAD
QA Service Level1 (Verified on 01/08/2019)

Sample Information

Sample Taken Date06/11/2018 Sample Unique Key9
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 testing06/13/2018
Sample typeVerification A brief description of the samplePSE, 3/4 Cold feded and Rap
The quantity of what the sample constitutesPSE 2 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byG Last name of sampler or witnessed byAlvarez
Title of samplerConsultant Telephone number of samplerUnknown
Laboratory sample identificationD77445 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameWard Lake Hat Crk Construction Transportation Laboratory (TL) NumberT101 C876220
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C876220 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 collectedAt the 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 JMF Verification ID
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2018-06-11-9-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/14/2018Terry McCormick
No
PSE, 3/4 Cold feed. Info
2018-06-11-9-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/14/2018Terry McCormick
No
PSE, rap extraction grading. Info
2018-06-11-9-3AASHTO 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 Lab06/14/2018Terry McCormick
No
PSE, Rap rice. Info