Sample Record

Owner Lab

  • CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2021-01-13-32

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 213653
DEA: 044G8204
EFIS: 0413000049
DIST-CO-RTE-PM04-MRN-101-10.6/10.8
Award Date05/05/2020
Closeout DateNot set
Work DescriptionREPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location DescriptionMARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
QA Service Level1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date01/13/2021 Sample Unique Key32
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 testing02/09/2021
Sample typeAnnual Source Testing A brief description of the sample4-small bags 3/4,1/2,3/8,#4
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byJulio Last name of sampler or witnessed byP
Title of samplerConsultant Telephone number of sampler
Laboratory sample identification21-PCCC-0020 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHanson Clayton Transportation Laboratory (TL) NumberC876397
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)91-07-0003
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 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
2021-01-13-32-1CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium SulfateBang NguyenCT HQ - Sacramento Aggregate Testing Laboratory03/01/2021Bang Nguyen
Yes
03/01/2021