Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2020-02-25-12

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212501
DEA: 022E4804
EFIS: 0200000586
DIST-CO-RTE-PM02-SIS-96,263-103.1/103.6,56.8/57.2
Award Date12/14/2018
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date02/25/2020 Sample Unique Key12
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 testing02/25/2020
Sample typeAcceptance A brief description of the sampleCoarse Aggregate (1 inch x No. 4)
The quantity of what the sample constitutes60 yd (Day's Concrete) From where was the sample collectedManufacturer
First name of sampler or witnessed byKaren Last name of sampler or witnessed bySpliethof
Title of samplerTET Telephone number of sampler
Laboratory sample identificationD78333A Linked DIME Sample ID2020-02-25-13
The fabricator/manufacturer/facility nameMountain Ready Mix Transportation Laboratory (TL) Number001681
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)91-47-0014::MOORES GRAVEL
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 collectedBelt at Plant
Where the material sample would have been placed if not sampledLeft Retaining Wall Footing of Abutment 8 Primary Aggregate Nominal Size1 inch
The concrete mix design numberCT675S Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2020-02-25-12-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesKaren SpliethofCT D02 - North Region Materials Lab02/26/2020Ward Jenkins
Yes
03/11/2020
2020-02-25-12-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Karen SpliethofCT D02 - North Region Materials Lab02/26/2020Ward Jenkins
Yes
03/11/2020