Sample Record

Owner Lab

  • Jaxon Enterprises - Deer Creek Rock & Asphalt

DIME Sample ID 2021-02-05-22

Project Information

Project IdentifiersProject ID: 66666
DEA: APP
EFIS: 0019000052
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for Aggregate Pre-approval Program (APP). Object Code: 1025. J2 DEA: 912680.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date02/05/2021 Sample Unique Key22
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing02/07/2021
Sample typeAggregate Prequalification Program A brief description of the sample1"x#4 APP
The quantity of what the sample constitutesabout 140 lb From where was the sample collectedSource
First name of sampler or witnessed byJordan Baker Last name of sampler or witnessed byJordan Baker
Title of samplerQC Manager Telephone number of sampler530-227-0982
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDeer Creek Rock and Asphalt Transportation Laboratory (TL) Number
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)91-54-0021
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 at source
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
2021-02-05-22-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesCGI Technician Jaxon Enterprises - Deer Creek Rock & Asphalt02/08/2021Jordan Baker
Yes
03/04/2021
2021-02-05-22-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)CGI Technician Jaxon Enterprises - Deer Creek Rock & Asphalt02/08/2021Jordan Baker
Yes
03/04/2021
2021-02-05-22-3CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing MachineCGI Technician Jaxon Enterprises - Deer Creek Rock & Asphalt02/08/2021Jordan Baker
Yes
03/04/2021
2021-02-05-22-4CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium SulfateCGI Technician Jaxon Enterprises - Deer Creek Rock & Asphalt02/08/2021Jordan Baker
Yes
03/04/2021