Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2019-04-25-15
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Project Information
| Project Identifiers | Project ID: 210808 DEA: 020E0904 EFIS: 0200000016 |
|---|---|
| DIST-CO-RTE-PM | 02-SHA-5-R29.3/R31.1,R45.0/R45.8 |
| Award Date | 02/03/2016 |
| Closeout Date | 10/21/2020 |
| Work Description | REPLACE BRIDGE, REALIGN ROADWAY AND SEISMIC RETROFIT |
| Location Description | IN SHASTA COUNTY ABT 8 MI N OF SHASTA LAKE CTY AND NEAR LAKEHEAD FRM TURNTABLE BAY O/C TO 0.1 MI N OF O'BRIEN SRRA & FRM 0.4 MI S TO 0.3 MI N OF DOG CREEK BRIDGE. |
| QA Service Level | 1 (Verified on 09/23/2015) |
Sample Information
| Sample Taken Date | 04/25/2019 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 | 04/25/2019 |
| 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 | Josh | Last name of sampler or witnessed by | Williams |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | D77852A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Northstate Asphalt | Transportation Laboratory (TL) Number | 001902 |
| 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 | L190276 |
| 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 19-09-S1 | Lot number | 0 |
| Sublot number | 0 | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2019-63 | Date Created | 05/24/2019 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2019-93 | JMF Status | Submittal Rejected For Use |
| Producer Mix ID | L190276 | Rejected Date | 05/30/2019 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-04-25-15-1 AASHTO T27-14 (Verified)