DIME - Sample Record for DIME Sample ID 2020-03-19-10

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Sample Record

Owner Lab

CT D02 - Redding Northern Regional Laboratory

DIME Sample ID 2020-03-19-10

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Project Information

Project Identifiers	Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125
DIST-CO-RTE-PM	02-SHA-5-R3.8/R11.7
Award Date	11/06/2018
Closeout Date	08/16/2023
Work Description	WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location Description	SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level	1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date	03/19/2020	Sample Unique Key	10
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	03/20/2020
Sample type	Verification	A brief description of the sample	3/4-inch Type A Aggregate (Treated, Virgin)
The quantity of what the sample constitutes	JMF Renewal	From where was the sample collected	Source
First name of sampler or witnessed by	Karen	Last name of sampler or witnessed by	Spliethof
Title of sampler	TET	Telephone number of sampler
Laboratory sample identification	D78360A	Linked DIME Sample ID	2020-03-19-11
The fabricator/manufacturer/facility name	Fawndale Rock and Asphalt - Redding, CA	Transportation Laboratory (TL) Number	001698
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)	91-45-0017::FAWNDALE ROCK QUARRY
The fabricator's/manufacturer's product name for the sample	19-1001.314	The fabricator/manufacturer designation for the sample	Unknown
The plant number	Unknown	A detailed description of where the material sample was collected	Cold Feed
Where the material sample would have been placed if not sampled	Unknown	Primary Aggregate Nominal Size	3/4 inch
The concrete mix design number	JMF 19-01-R1	Lot number	Unknown
Sublot number	Unknown	Aggregate Mix Number	Not set

JMF Information

Verification ID	JMF3513-2020-105	Date Created	04/07/2020
JMF Submittal ID	JMF3511-22-2020-149	JMF Status	Submittal Authorized For Use
Producer Mix ID	19-1001.314	Authorized Date	04/13/2020

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments	Actions
2020-03-19-10-1	AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)	Ward Jenkins, CT D02 - Redding Northern Regional Laboratory	03/23/2020	Ward Jenkins	Yes	04/07/2020

Sample File Attachments

File Name	Extension	Date Uploaded	Actions
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Test File Attachments

DIME Test ID: 2020-03-19-10-1 AASHTO T27-14 (Verified)