Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2020-10-15-17

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 Date10/15/2020 Sample Unique Key17
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 testing10/15/2020
Sample typeAggregate Prequalification Program A brief description of the sample1.0" PCC Aggregates
The quantity of what the sample constitutes13 Bags From where was the sample collectedSource
First name of sampler or witnessed byRamy Last name of sampler or witnessed byMekail
Title of samplerTET Telephone number of sampler
Laboratory sample identification2293 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRobertsons - Cabazon Transportation Laboratory (TL) NumberC030797
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)91-33-0008
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 collectedPlant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.