Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-05-04-21

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212496
DEA: 024E4504
EFIS: 0200020286
DIST-CO-RTE-PM02-LAS,MOD-139,299-VAR
Award Date07/28/2020
Closeout DateNot set
Work DescriptionPLACE HMA, REPLACE DRAINAGE, CULVERT, ELECTRICAL AND LIGHTING SYSTEMS.
Location DescriptionLASSEN AND MODOC COUNTIES ON ROUTE 139 AT 0.1 MILE NORTH OF LASSEN COUNTY LINE AND ON ROUTE 299 AT VARIOUS LOCATONS FROM 0.4 MILE WEST OF BOYD HILL LOOKOUT ROAD TO 0.6 MILE EAST OF COUNTY ROAD 87
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date05/04/2021 Sample Unique Key21
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 testing05/05/2021
Sample typeAcceptance A brief description of the sample3/4" Class II AB
The quantity of what the sample constitutesUnknown From where was the sample collectedJob Site
First name of sampler or witnessed byE. Last name of sampler or witnessed byChavez
Title of sampler Telephone number of sampler
Laboratory sample identificationD78790 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHat Creek Construction Transportation Laboratory (TL) Number765844
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)Hat Creek Lookout, CA
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 collected02-LAS,MOD-139,299 VAR, EB A Line Route 299 at STA 1365 plus 50
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 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
2021-05-04-21-1CTM 229-June 2011: Method of Test for Durability IndexTerry McCormickCT D02 - North Region Materials Lab05/06/2021Darrell Valasek
Yes
07/02/2021
2021-05-04-21-2CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesTerry McCormickCT D02 - North Region Materials Lab05/06/2021Darrell Valasek
Yes
07/02/2021
2021-05-04-21-3CTM 301-March 2000: Method for Determining the Resistance "R" Value of Treated and Untreated Bases, Subbases, and Basement Soils by the StabilometerTerry McCormickCT D02 - North Region Materials Lab05/11/2021Darrell Valasek
Yes
07/02/2021