Sample Record
Owner Lab
- CT D02 - North Region Materials Lab
DIME Sample ID 2020-06-08-44
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214589 DEA: 020J1604 |
|---|---|
| DIST-CO-RTE-PM | 02-PLU-284-0.0/8.3 |
| Award Date | 02/11/2020 |
| Closeout Date | 10/06/2020 |
| Work Description | PLACE HMA (TYPE A), PRECOATED AGGREGATE (SEAL COAT), HMA (LEVELING). |
| Location Description | PLUMAS COUNTY NEAR CHILCOOT FROM ROUTE 70 TO 1 MILE NORTH OF LITTLE LAST CHANCE CREEK BRIDGE NUMBER 09-0072 |
| QA Service Level | 1 (Verified on 01/22/2020) |
Sample Information
| Sample Taken Date | 06/08/2020 | Sample Unique Key | 44 |
|---|---|---|---|
| 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 | 06/09/2020 |
| Sample type | Verification | A brief description of the sample | 3/4-inch Type A Treated Virgin Aggregate |
| The quantity of what the sample constitutes | JMF Verification and PSE | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | CGI | Last name of sampler or witnessed by | CGI |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D78460A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Ward Lake Plant, Litchfield, CA | Transportation Laboratory (TL) Number | 896981 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA or name of Pit) | 91-18-0008 |
|---|---|---|---|
| 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 | Cold Feed | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/4 inch | |
| The concrete mix design number | JMF 20-03-S4 | Lot number | 1 |
| Sublot number | 1 | JMF Verification ID | JMF3513-2020-192 |