Sample Record

Owner Lab

  • CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2020-12-04-17

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 214114
DEA: 040A5394
EFIS: 0418000244
DIST-CO-RTE-PM04-SOL-80,12-11.4/12.8, 2.1/2.8
Award DateNot set
Closeout DateNot set
Work DescriptionWiden EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc.
Location DescriptionI-80/I-680/Route 12 Interchange
QA Service Level1 (Verified on 04/23/2019)

Sample Information

Sample Taken Date12/04/2020 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 testing12/22/2020
Sample typeQuality Assurance A brief description of the sampleFine
The quantity of what the sample constitutes1 bags From where was the sample collectedSource
First name of sampler or witnessed byplant Last name of sampler or witnessed byplant
Title of samplerQC lab tech Telephone number of sampler
Laboratory sample identification20-FPCC-0241 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCemex Madison Cache Creek Transportation Laboratory (TL) NumberC043706
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)91-57-0008
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 collectedStockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Sizefine
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
2020-12-04-17-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandBang NguyenCT HQ - Sacramento Aggregate Testing Laboratory12/24/2020Bang Nguyen
Yes
01/08/2021