Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-04-01-31

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212501
DEA: 022E4804
EFIS: 0200000586
DIST-CO-RTE-PM02-SIS-96,263-103.1/103.6,56.8/57.2
Award Date12/14/2018
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 8 MILES NORTH OF YREKA ON ROUTE 96 FROM 0.5 MILE WEST TO 0.2 MILE EAST OF ROUTE 263 AND ON ROUTE 263 FROM 0.3 MILE NORTH OF SHASTA RIVER BRIDGE #02-0014 TO ROUTE 96
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date04/01/2021 Sample Unique Key31
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 testing04/05/2021
Sample typeAuthorization A brief description of the sample3/4-inch Maximum Class 2 Aggregate Base
The quantity of what the sample constitutesProcess From where was the sample collectedSource
First name of sampler or witnessed byDanny Last name of sampler or witnessed byHanson
Title of sampler Telephone number of sampler
Laboratory sample identificationD78756 Linked DIME Sample ID
The fabricator/manufacturer/facility nameRoadway Transportation Laboratory (TL) Number897282
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)Undeclared
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 collectedGrindings from Hwy 96
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 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
2021-04-01-31-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesK. Rios Dorado and D. HickeyCT D02 - North Region Materials Lab04/06/2021Ward Jenkins
Yes
05/14/2021
2021-04-01-31-2CTM 217-June 2011: Method of Test for Sand EquivalentColt SweenyCT D02 - North Region Materials Lab04/06/2021Ward Jenkins
Yes
05/14/2021The SE is 44.
2021-04-01-31-3CTM 301-March 2000: Method of Test for Determining the Resistance "R"; Value of Treated and Untreated Bases, Subbases, and Basement Soils by the StabilometerDennis HickeyCT D02 - North Region Materials Lab04/15/2021Ward Jenkins
Yes
05/14/2021