Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2019-04-18-13
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Project Information
| Project Identifiers | Project ID: 213336 DEA: 023E7404 EFIS: 0200020160 |
|---|---|
| DIST-CO-RTE-PM | 02-SHA-299-R7.6/18.3 |
| Award Date | 08/24/2018 |
| Closeout Date | 09/02/2020 |
| Work Description | PAVEMENT PRESERVATION |
| Location Description | SHASTA COUNTY AT AND NEAR SHASTA FROM 0.5 MILE WEST OF CRYSTAL CREEK ROAD TO TRINITY ALLEY |
| QA Service Level | 1 (Verified on 01/08/2019) |
Sample Information
| Sample Taken Date | 04/18/2019 | Sample Unique Key | 13 |
|---|---|---|---|
| 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 | 04/18/2019 |
| Sample type | Verification | A brief description of the sample | 3/4-inch Type A Treated Virgin Aggregate |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Dorell | Last name of sampler or witnessed by | Harper |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D77836A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Northstate Asphalt | Transportation Laboratory (TL) Number | 728565 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-45-0057::SHASTA RANCH AGGREGATES |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | L190300 |
| The plant number | Unknown | A detailed description of where the material sample was collected | Cold Feed |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | 3/4 inch |
| The concrete mix design number | JMF 19-07-S1 | Lot number | 0 |
| Sublot number | 0 | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2019-61 | Date Created | 05/14/2019 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2019-90 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | L190300 | Authorized Date | 05/20/2019 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-04-18-13-1 AASHTO T27-14 (Verified)