Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2013-06-21-7037731

Project Information

Project IdentifiersProject ID: 7629
DEA: 060J0404
EFIS: 0600000156
DIST-CO-RTE-PM06-KIN-41-R37.5/R38.1
Award Date10/29/2012
Closeout Date06/21/2013
Work DescriptionCONTSTRUCT LEFT TURN CHANNELIZATION AND INSTALL LIGHTING.
Location DescriptionKINGS COUNTY NEAR LEMOORE FROM 0.3 MILE SOUTH OF JACKSON AVENUE TO 0.3 MILE NORTH OF JACKSON AVENUE
QA Service Level1 (Verified on 09/24/2012)

Sample Information

Sample Taken Date06/21/2013 Sample Unique Key7037731
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 testing06/18/2013
Sample typeAnnual Source Testing A brief description of the sampleSand
The quantity of what the sample constitutes1Bag From where was the sample collectedSource
First name of sampler or witnessed byDallia Last name of sampler or witnessed byFoster
Title of samplerTe Telephone number of samplerNot set
Laboratory sample identification13FPCC-0259 / C875895 Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameJ/Baker Auenal Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)None
The fabricator's/manufacturer's product name for the sampleNot set The fabricator/manufacturer designation for the sampleNot set
The plant numberNot set A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampledNot set Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2013-06-21-7037731-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandThomas StinnettCT HQ - Sacramento Aggregate Testing Laboratory06/21/2013Thomas Stinnett
Yes
06/21/2013