Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2021-05-18-24

Project Information

Project IdentifiersProject ID: 214336
DEA: 07302404
EFIS: 0713000488
DIST-CO-RTE-PM07-VEN-101-37/40
Award DateNot set
Closeout DateNot set
Work DescriptionPADRE JUAN REHAB
Location DescriptionVEN 101
QA Service Level1 (Verified on 02/26/2021)

Sample Information

Sample Taken Date05/18/2021 Sample Unique Key24
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 testing05/21/2021
Sample typeVerification A brief description of the sampleJMF 3/4" RHMA_G 0.5% LAS
The quantity of what the sample constitutes4 Bags Of Combined Agg., From where was the sample collectedManufacturer
First name of sampler or witnessed byHonesto Last name of sampler or witnessed byCastillo
Title of sampler Telephone number of sampler
Laboratory sample identification0297G-21 Linked DIME Sample ID
The fabricator/manufacturer/facility nameGranite Construction Co Santa Paula 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)91-19-0046::BIG ROCK CREEK- GRANITE
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number1556 A detailed description of where the material sample was collectedBelt Cut at Granite Santa Paula Plant
Where the material sample would have been placed if not sampledAsphalt Paving Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number JMF Verification ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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