Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-09-24-7

Project Information

Project IdentifiersProject ID: 212816
DEA: 020H6304
EFIS: 0215000063
DIST-CO-RTE-PM02-LAS-139-6.2/7.3
Award Date06/29/2018
Closeout Date12/04/2019
Work DescriptionROADWAY EXCAVATION, AGGREGATE BASE, HOT MIX ASPHALT, GUARDRAIL
Location DescriptionLASSEN COUNTY ABOUT 6 MILES NORTH OF SUSANVILLE FROM 1.0 MILE SOUTH TO 0.1 MILE SOUTH OF ANTELOPE RADIO STREET
QA Service Level1 (Verified on 01/17/2018)

Sample Information

Sample Taken Date09/24/2018 Sample Unique Key7
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 testing09/25/2018
Sample typeAcceptance A brief description of the samplePSE 3/4 Cold feed and rap
The quantity of what the sample constitutesPSE 2 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byGabe Last name of sampler or witnessed byAlvarez
Title of samplerConsultant Telephone number of samplerUnknown
Laboratory sample identificationD77662 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameWard Lake Hat Crk Construction Transportation Laboratory (TL) NumberT101 C 990868
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C 990868 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 sampleCold 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 HMA Design ID
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2018-09-24-7-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab10/03/2018Terry McCormick
No
PSE, 3/4 cold feed Info
2018-09-24-7-2AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab10/03/2018Terry McCormick
No
PSE, rap extraction grading. Info
2018-09-24-7-3AASHTO 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 Lab10/01/2018Terry McCormick
No
PSE, rap rice Info