Sample Record

Owner Lab

  • CGI Technical Services, Incorporated

DIME Sample ID 2019-04-01-8

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212753
DEA: 020H7604
EFIS: 0215000086
DIST-CO-RTE-PM02-LAS,PLU-VAR-VAR
Award Date03/28/2019
Closeout Date09/02/2020
Work DescriptionFULL DEPTH RECLAMATION AND DRAINAGE REHABILITATION
Location DescriptionLASSEN AND PLUMAS COUNTIES AT AND NEAR CHILCOOT FROM 0.9 MILE WEST OF SUMMIT SCHOOL DRIVE TO 0.7 MILE EAST OF ROUTE 395
QA Service Level1 (Verified on 01/08/2019)

Sample Information

Sample Taken Date04/01/2019 Sample Unique Key8
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 testing04/01/2019
Sample typeQuality Control A brief description of the sample3/4-inch
The quantity of what the sample constitutesproduction stockpile. From where was the sample collectedSource
First name of sampler or witnessed byTed Last name of sampler or witnessed byKinsey
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameHat Creek - Ward Lake Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-18-0008
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedPlant Stockpile
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown Aggregate Mix NumberNot set

JMF Information

HMA Design IDJMF3512-2019-98-19-1278.106 Date Created05/08/2019
SubmittalJMF3511-227-2019-85 Submittal Authorized For Use| JMF3513-2019-84

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-04-01-8-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Ted Kinsey, CGI Technical Services, Incorporated04/02/2019Vikram Kyatham
Yes
05/08/2019

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2019-04-01-8-1 AASHTO T27-14 (Verified)