DIME - Sample Record for DIME Sample ID 2018-11-28-17

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Sample Record

Owner Lab

CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2018-11-28-17

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Project Information

Project Identifiers	Project ID: 213002 DEA: 042640N4 EFIS: 0412000649
DIST-CO-RTE-PM	04-MRN,SON-101-MRN27.0/27.6SON0.0/4.5
Award Date	04/09/2018
Closeout Date	03/12/2021
Work Description	CONSTRUCT HOV LANES
Location Description	MARIN AND SONOMA COUNTIES IN AND NEAR PETALUMA FROM 0.6 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE TO 0.3 MILE SOUTH OF EAST WASHINGTON STREET OVER CROSSING
QA Service Level	1 (Verified on 04/13/2018)

Sample Information

Sample Taken Date	11/28/2018	Sample Unique Key	17
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 testing	02/06/2019
Sample type	Annual Source Testing	A brief description of the sample	Fine
The quantity of what the sample constitutes	1 bag	From where was the sample collected	Source
First name of sampler or witnessed by	CJ	Last name of sampler or witnessed by	Sousa
Title of sampler	Plant QC	Telephone number of sampler
Laboratory sample identification	19-FPCC-0019	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Healdsburg Quarry	Transportation Laboratory (TL) Number	C805889
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier	Not set
Structure name	Not set

Material Information

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	91-49-0062::HEALDSBURG TERRACE PHASE VI
The fabricator's/manufacturer's product name for the sample	Unknown	The fabricator/manufacturer designation for the sample	Unknown
The plant number	Unknown	A detailed description of where the material sample was collected	Stockpile
Where the material sample would have been placed if not sampled	Unknown	Primary Aggregate Nominal Size	fine
The concrete mix design number	Unknown	Lot number	0
Sublot number	0	Aggregate Mix Number	Not set

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments
2018-11-28-17-1	THIS TEST HAS BEEN SUPERSEDED. CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand	Bang Nguyen, CT HQ - Sacramento Aggregate Testing Laboratory	03/15/2019	Bang Nguyen	Yes	03/22/2019	THIS TEST HAS BEEN SUPERSEDED.
2018-11-28-17-2	THIS TEST HAS BEEN SUPERSEDED. CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium Sulfate	Bang Nguyen, CT HQ - Sacramento Aggregate Testing Laboratory	03/15/2019	Bang Nguyen	Yes	03/22/2019	THIS TEST HAS BEEN SUPERSEDED.
2018-11-28-17-3	CTM 213-December 2012: Method of Test for Organic Impurities in Concrete Sand	Bang Nguyen, CT HQ - Sacramento Aggregate Testing Laboratory	03/15/2019	Bang Nguyen	Yes	03/15/2019
2018-11-28-17-4	CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium Sulfate	Bang Nguyen, CT HQ - Sacramento Aggregate Testing Laboratory	03/15/2019	Bang Nguyen	Yes	03/15/2019

Sample File Attachments

File Name	Extension	Date Uploaded	Actions
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Test File Attachments

DIME Test ID: 2018-11-28-17-1 CTM 213-December 2012 (Verified)
DIME Test ID: 2018-11-28-17-2 CTM 214-August 2010 (Verified)
DIME Test ID: 2018-11-28-17-3 CTM 213-December 2012 (Verified)
DIME Test ID: 2018-11-28-17-4 CTM 214-August 2010 (Verified)