Sample Record

Owner Lab

  • Gallagher and Burk Materials

DIME Sample ID 2020-04-01-23

Project Information

Project IdentifiersProject ID: 66667
DEA: JMFPP
EFIS: 0019000043
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for JMF Prequalification Program.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date04/01/2020 Sample Unique Key23
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 testing04/01/2020
Sample typeAggregate Prequalification Program A brief description of the sample1/2" Cold feed
The quantity of what the sample constitutes20000 tons From where was the sample collectedJob Site
First name of sampler or witnessed byDon Last name of sampler or witnessed byEvans
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDeSilva Gates Aggregates 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)91-01-0007::SUNOL
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 collectedFeeder Conveyor Belt
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size1/2 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID JMF3512-2020-184-MD6757

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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