Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2021-02-08-17

Project Information

Project IdentifiersProject ID: 214422
DEA: 040J6424
EFIS: 0414000476
DIST-CO-RTE-PM04-SON-101-32.8/R54.2
Award Date12/24/2019
Closeout DateNot set
Work DescriptionCRACK, SEAT AND OVERLAY WITH RHMA AND HMA, AND REPLACE CULVERTS.
Location DescriptionSONOMA COUNTY AT VARIOUS LOCATIONS FROM LIMERICK LANE OVERCROSSING TO ROUTE 101/128 SEPARATION
QA Service Level1 (Verified on 09/23/2019)

Sample Information

Sample Taken Date02/08/2021 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 testing02/08/2021
Sample typeAnnual Source Testing A brief description of the sample1" X #4
The quantity of what the sample constitutes6 Bags From where was the sample collectedSource
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of samplerConsultant Tester Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameMark West Quarry Transportation Laboratory (TL) NumberC044319
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)91-49-0032
The fabricator's/manufacturer's product name for the sampleMark West Quarry 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 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
2021-02-08-17-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesAnthony ValdezCT D04 - Petaluma Field Laboratory02/10/2021Glenn Cea
No
Info
2021-02-08-17-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Anthony ValdezCT D04 - Petaluma Field Laboratory02/10/2021Glenn Cea
No
Info