Sample Record

Owner Lab

  • CT HQ - Sacramento Aggregate Testing Laboratory

DIME Sample ID 2021-01-05-25

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 214601
DEA: 041J5694
EFIS: 0419000313
DIST-CO-RTE-PM04-SM-101-0.0/21.8
Award DateNot set
Closeout DateNot set
Work DescriptionBarrier modifications, overhead signs, freeway lighting and electronic toll system components
Location DescriptionSANTA CLARA AND SAN MATEO COUNTIES FROM 0.3 MILE NORTH OF SAN ANTONIO ROAD TO 0.3 MILE SOUTH OF GRAND AVENUE INTERCHANGE
QA Service Level1 (Verified on 02/21/2020)

Sample Information

Sample Taken Date01/05/2021 Sample Unique Key25
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 testing04/01/2021
Sample typeAnnual Source Testing A brief description of the sampleconcrete sand
The quantity of what the sample constitutes1 bag From where was the sample collectedSource
First name of sampler or witnessed byL Last name of sampler or witnessed byMagana
Title of samplerConsultant Telephone number of sampler
Laboratory sample identification21-PCCF-0057 Linked DIME Sample ID
The fabricator/manufacturer/facility nameP92 101 Sand Hanson Transportation Laboratory (TL) NumberC924561
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)07-008-013
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 Sizefine
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
2021-01-05-25-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandRyan KesterCT HQ - Sacramento Aggregate Testing Laboratory04/05/2021Bang Nguyen
Yes
04/16/2021