Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2019-10-31-21
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Project Information
| Project Identifiers | Project ID: 213002 DEA: 042640N4 EFIS: 0412000649 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN,SON-101-MRN27.0/27.6SON0.0/4.5 |
| Award Date | 04/09/2018 |
| Closeout Date | 03/12/2021 |
| Work Description | CONSTRUCT HOV LANES |
| Location Description | MARIN AND SONOMA COUNTIES IN AND NEAR PETALUMA FROM 0.6 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE TO 0.3 MILE SOUTH OF EAST WASHINGTON STREET OVER CROSSING |
| QA Service Level | 1 (Verified on 04/13/2018) |
Sample Information
| Sample Taken Date | 10/31/2019 | Sample Unique Key | 21 |
|---|---|---|---|
| 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 | 10/31/2019 |
| Sample type | Annual Source Testing | A brief description of the sample | 1" X #4 |
| The quantity of what the sample constitutes | 6 Bags | From where was the sample collected | Source |
| First name of sampler or witnessed by | Anthony | Last name of sampler or witnessed by | Valdez |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Syar Lake Herman | Transportation Laboratory (TL) Number | 870910 |
| 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) | 91-48-0002::LAKE HERMAN QUARRY |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| The plant number | Unknown | A detailed description of where the material sample was collected | stockpile |
| Where the material sample would have been placed if not sampled | Unknown | Primary Aggregate Nominal Size | 1 inch |
| The concrete mix design number | Unknown | Lot number | Unknown |
| Sublot number | Unknown | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| 2019-10-31-21-2 | CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse Aggregates | Jaccob Cruz, CT D04 - Petaluma Field Laboratory | 10/31/2019 | Glenn Cea | No | Info | ||
| 2019-10-31-21-3 | CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness) | Jaccob Cruz, CT D04 - Petaluma Field Laboratory | 10/31/2019 | Glenn Cea | No | Info |
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-10-31-21-2 CTM 202-November 2011
DIME Test ID: 2019-10-31-21-3 CTM 227-December 2014