DIME - Sample Record for DIME Sample ID 2021-01-13-32

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Sample Record

Owner Lab

CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2021-01-13-32

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Project Information

Project Identifiers	Project ID: 213653 DEA: 044G8204 EFIS: 0413000049
DIST-CO-RTE-PM	04-MRN-101-10.6/10.8
Award Date	05/05/2020
Closeout Date	08/14/2023
Work Description	REPLACE SAN RAFAEL HARBOR BRIDGE (ABC)
Location Description	MARIN COUTY, IN SAN RAFAEL, FROM ROUTE 101 NORTHBOUND OFF-RAMP TO 2ND STREET
QA Service Level	1 (Verified on 05/31/2019)

Sample Information

Sample Taken Date	01/13/2021	Sample Unique Key	32
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 testing	02/09/2021
Sample type	Annual Source Testing	A brief description of the sample	4-small bags 3/4,1/2,3/8,#4
The quantity of what the sample constitutes	1 bag	From where was the sample collected	Source
First name of sampler or witnessed by	Julio	Last name of sampler or witnessed by	P
Title of sampler	Consultant	Telephone number of sampler
Laboratory sample identification	21-PCCC-0020	Linked DIME Sample ID
The fabricator/manufacturer/facility name	Hanson Clayton	Transportation Laboratory (TL) Number	C876397
Inspector Lot Number from the Transportation Laboratory (TL) Form		Structure unique identifier
Structure name

Material Information

Material Type	Aggregate	Source Identification (SMARA, name of Pit or Job Site)	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 collected	Stockpile
Where the material sample would have been placed if not sampled		Primary Aggregate Nominal Size	1 inch
The concrete mix design number		Lot number
Sublot number		Aggregate Mix Number	Not set

Submitted Tests

DIME Test ID	Test Method	Tester Name, Testing Lab	Date Tested	Submitted By	Verified?	Release Date	Test Comments	Actions
2021-01-13-32-1	CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium Sulfate	Bang Nguyen, CT HQ - Sacramento Aggregate Testing Laboratory	03/01/2021	Bang Nguyen	Yes	03/01/2021

Sample File Attachments

File Name	Extension	Date Uploaded	Actions
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Test File Attachments

DIME Test ID: 2021-01-13-32-1 CTM 214-August 2010 (Verified)