Sample Record

Owner Lab

  • Sousa Ready Mix, LLC

DIME Sample ID 2018-03-06-15

Project Information

Project IdentifiersProject ID: 213337
DEA: 024F5404
EFIS: 0213000004
DIST-CO-RTE-PM02-SIS-5-R15.3/R16.5
Award Date07/30/2018
Closeout Date05/23/2022
Work DescriptionBRIDGE REPLACEMENT - SOUTHBOUND ONLY
Location DescriptionSISKIYOU COUNTY NEAR WEED FROM 0.1 MILE SOUTH OF DEETZ ROAD UNDERCROSSING TO 0.6 MILE NORTH OF BLACK BUTTE OVERHEAD 02-0004L
QA Service Level1 (Verified on 11/14/2018)

Sample Information

Sample Taken Date03/06/2018 Sample Unique Key15
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 testing03/06/2018
Sample typeInformational A brief description of the sample1x#4 Concrete Aggregate
The quantity of what the sample constitutes200 lbs From where was the sample collectedManufacturer
First name of sampler or witnessed byGreg Last name of sampler or witnessed byJuell
Title of samplerManaging Member Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSousa Ready Mix, LLC Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-47-0015
The fabricator's/manufacturer's product name for the sample1 inch Rock The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedUnknown
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberNot set
Sublot numberNot set Aggregate Mix NumberNot set
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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