Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2019-10-31-21

Project Information

Project IdentifiersProject ID: 213002
DEA: 042640N4
EFIS: 0412000649
DIST-CO-RTE-PM04-MRN,SON-101-MRN27.0/27.6SON0.0/4.5
Award Date04/09/2018
Closeout Date03/12/2021
Work DescriptionCONSTRUCT HOV LANES
Location DescriptionMARIN 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 Level1 (Verified on 04/13/2018)

Sample Information

Sample Taken Date10/31/2019 Sample Unique Key21
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 testing10/31/2019
Sample typeAnnual Source Testing A brief description of the sample1" X #4
The quantity of what the sample constitutes6 Bags From where was the sample collectedSource
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameSyar Lake Herman Transportation Laboratory (TL) Number870910
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-48-0002::LAKE HERMAN QUARRY
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedstockpile
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-10-31-21-2CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesJaccob CruzCT D04 - Petaluma Field Laboratory10/31/2019Glenn Cea
No
Info
2019-10-31-21-3CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Jaccob CruzCT D04 - Petaluma Field Laboratory10/31/2019Glenn Cea
No
Info