Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2018-10-11-5

Project Information

Project IdentifiersProject ID: 212886
DEA: 023H1204
DIST-CO-RTE-PM02-TEH-5-R0.0/R22.4
Award Date01/03/2018
Closeout Date02/06/2019
Work DescriptionCOLD PLANE RAC-O, PLACE RHMA-O, REPLACE AC SURFACING, MBGR
Location DescriptionTEHAMA COUNTY AT AND NEAR CORNING FROM GLENN COUNTY LINE TO 0.3 MILE NORTH OF BRANCH COYOTE CREEK BRIDGE
QA Service Level1 (Verified on 01/08/2019)

Sample Information

Sample Taken Date10/11/2018 Sample Unique Key5
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 testing10/12/2018
Sample typeAcceptance A brief description of the sample3/4 Cold feed
The quantity of what the sample constitutes1 bag From where was the sample collectedManufacturer
First name of sampler or witnessed byCheryl Last name of sampler or witnessed byAbraham
Title of samplerTET Telephone number of samplerUnknown
Laboratory sample identificationD77693 Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameTullis Inc - Northstate Asphalt - Redding, CA Transportation Laboratory (TL) NumberT101 C990844
Inspector Lot Number from the Transportation Laboratory (TL) FormT101 C990844 Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-45-0057
The fabricator's/manufacturer's product name for the sample3/4 Cold feed 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
2018-10-11-5-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab10/16/2018Terry McCormick
No
3/4 cold feed. Info