Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-04-09-27

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 214190
DEA: 024G41U4
EFIS: 0218000047
DIST-CO-RTE-PM02-SIS,SIS-5-Var
Award Date08/26/2019
Closeout Date11/24/2021
Work DescriptionREPLACE REINFORCED CONCRETE BRIDGES & CONSTRUCT RETAINING WALL.
Location DescriptionSHASTA AND SISKIYOU COUNTIES ABOUT 7 MILES NORTH OF POLLARD FLAT FROM 0.8 MILE SOUTH TO 0.7 MILE NORTH OF SIMS ROAD UNDERCROSSING AND FROM 0.6 MILE SOUTH OF CASTLE CRAGS DRIVE UNDERCROSSING TO 0.2 MILE SOUTH OF SOUTH DUNSMUIR UNDERCROSSING
QA Service Level1 (Verified on 07/09/2019)

Sample Information

Sample Taken Date04/09/2021 Sample Unique Key27
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 testing04/09/2021
Sample typeAcceptance A brief description of the sampleCoarse PCC Aggregate (3/8-inch x No. 8)
The quantity of what the sample constitutesUndefined From where was the sample collectedSource
First name of sampler or witnessed byKaren Last name of sampler or witnessed byDorado
Title of samplerJET Telephone number of sampler
Laboratory sample identificationD78770 Linked DIME Sample ID
The fabricator/manufacturer/facility nameJF Shea Construction, Shasta Redi-Mix, Redding, CA Transportation Laboratory (TL) Number002572
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)Undefined
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 collectedBelt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/8 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
2021-04-09-27-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesColt SweenyCT D02 - North Region Materials Lab04/12/2021Darrell Valasek
Yes
05/20/2021
2021-04-09-27-2CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Karen DoradoCT D02 - North Region Materials Lab04/13/2021Darrell Valasek
Yes
05/20/2021