Sample Record

Owner Labs

  • CT HQ - Sacramento Aggregate Testing Laboratory
  • CT - Southern Regional Laboratory

DIME Sample ID 2020-03-12-21

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 Date03/12/2020 Sample Unique Key21
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 sample3/8 Pea Gravel
The quantity of what the sample constitutes3 Bags From where was the sample collectedSource
First name of sampler or witnessed byMarc Last name of sampler or witnessed bySegura
Title of sampler Telephone number of sampler
Laboratory sample identification9537 Linked DIME Sample ID2020-03-11-19
The fabricator/manufacturer/facility nameCemex Lytle Creek 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)91-36-0040
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
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

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