Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2019-05-23-17
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Project Information
| Project Identifiers | Project ID: 211775 DEA: 024E6504 EFIS: 0212000012 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-96-R52.5/88.4 |
| Award Date | 07/10/2017 |
| Closeout Date | 01/05/2021 |
| Work Description | WIDEN BRIDGES,POLYESTER CONC OVERLAY,COLD PLANE AC PVMT,HMA,GUARDRAIL |
| Location Description | SISKIYOU COUNTY NEAR SEIAD VALLEY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF THOMPSON CREEK BRIDGE TO 0.2 MILE EAST OF BEAVER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 08/23/2017) |
Sample Information
| Sample Taken Date | 05/23/2019 | 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 | 05/23/2019 |
| Sample type | Verification | A brief description of the sample | Treated Virgin 3/4-inch Type A Aggregate |
| The quantity of what the sample constitutes | JMF Modification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Derrick | Last name of sampler or witnessed by | Curry |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D77889A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Fawndale Rock and Asphalt | Transportation Laboratory (TL) Number | 001377 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA or name of Pit) | 91-45-0017::FAWNDALE ROCK QUARRY |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | 18-1001.305-23.6_ |
| 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 18-03-M2 | Lot number | 0 |
| Sublot number | 0 | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2019-71 | Date Created | 06/27/2019 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2019-103 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 18-1001.305-23.6% | Authorized Date | 07/08/2019 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-05-23-17-1 AASHTO T27-14 (Verified)