Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2014-03-20-11077038

Project Information

Project IdentifiersProject ID: 6842
DEA: 04264144
EFIS: 0400002023
DIST-CO-RTE-PM04-NAP,SOL-12-2.8/3.3,0.0/2.6
Award Date12/31/1969
Closeout Date12/22/2016
Work DescriptionWIDEN ROUTE 12 FROM A TWO-LANE TO A FOUR-LANE CONVENTIONAL HIGHWAY
Location DescriptionNAPA AND SOLANO COUNTIES FROM 0.5 MILE WEST OF NAPA COUNTY LINE TO RED TOP ROAD
QA Service Level1 (Verified on 02/21/2012)

Sample Information

Sample Taken Date03/20/2014 Sample Unique Key11077038
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 testing03/03/2014
Sample typePer Request A brief description of the sampleSand
The quantity of what the sample constitutes1 Bag From where was the sample collectedSource
First name of sampler or witnessed byDanilo Last name of sampler or witnessed byPatenia
Title of samplerNot set Telephone number of samplerNot set
Laboratory sample identification14FPCC-0095 C872690 Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameCemex Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-39-0015
The fabricator's/manufacturer's product name for the sampleNot set The fabricator/manufacturer designation for the sampleNot set
The plant numberNot set A detailed description of where the material sample was collectedCemex Kerlinger Stockpile
Where the material sample would have been placed if not sampledNot set Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2014-03-20-11077038-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandThomas StinnettCT HQ - Sacramento Aggregate Testing Laboratory03/20/2014Thomas Stinnett
Yes
03/21/2014 

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