Sample Record

Owner Lab

  • Jaxon Enterprises - Deer Creek Rock & Asphalt

DIME Sample ID 2019-12-01-2

Project Information

Project IdentifiersProject ID: 66666
DEA: APP
EFIS: 0019000052
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date12/01/2019 Sample Unique Key2
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testingNot set
Sample typeAggregate Prequalification Program A brief description of the sampleConcrete agg 3/8" Crushed
The quantity of what the sample constitutes2 buckets From where was the sample collectedSource
First name of sampler or witnessed byJordan Last name of sampler or witnessed byBaker
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDeer Creek Rock and Aspahlt Transportation Laboratory (TL) Number
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)91-54-0021::DEER CREEK QUARRY
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedStockpile sample by loader bucket
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-12-01-2-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesCGI TechnicianJaxon Enterprises - Deer Creek Rock & Asphalt12/05/2019Jordan Baker
Yes
03/18/2020
2019-12-01-2-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)CGI TechnicianJaxon Enterprises - Deer Creek Rock & Asphalt12/06/2019Jordan Baker
Yes
03/18/2020
2019-12-01-2-3CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing MachineCGI TechnicianJaxon Enterprises - Deer Creek Rock & Asphalt12/05/2019Jordan Baker
Yes
03/18/2020
2019-12-01-2-4CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium SulfateCGI TechnicianJaxon Enterprises - Deer Creek Rock & Asphalt12/06/2019Jordan Baker
Yes
03/18/2020

Test Card Drafts

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