Sample Record
Owner Lab
- CT D04 - Hayward DME / District Laboratory
DIME Sample ID 2020-07-24-3
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Project Information
| Project Identifiers | Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 |
|---|---|
| DIST-CO-RTE-PM | 03-SAC,OMG-888,99,80-0.6-0.6 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES. |
| Location Description | THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES. |
| QA Service Level | 1 (Verified on 04/05/2013) |
Sample Information
| Sample Taken Date | 07/24/2020 | Sample Unique Key | 3 |
|---|---|---|---|
| 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 | 07/24/2020 |
| Sample type | Verification | A brief description of the sample | 1/2" Aggregate for HMA |
| The quantity of what the sample constitutes | 6 bags of virgin aggregate | From where was the sample collected | Source |
| First name of sampler or witnessed by | John | Last name of sampler or witnessed by | Doe |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Teichert Vernalis | Transportation Laboratory (TL) Number | |
| 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) | 91-39-0041::VERNALIS WEST & EAST PROPERTIES |
|---|---|---|---|
| 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 collected | Stockpile @ Plant | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1/2 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2020-164 | Date Created | 07/24/2020 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-318-2020-241 | JMF Status | Submittal Accepted for Verification |
| Producer Mix ID | TEST-VRN12SPAPNW6410XL9C | Authorized Date | N/A |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2020-07-24-3-1 AASHTO T27-14 (Verified)