Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-06-07-20

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215251
DEA: 021J4604
EFIS: 0220000081
DIST-CO-RTE-PM02-SIS-96-34.5/38.8,88.0/92.0
Award Date02/02/2021
Closeout Date09/27/2021
Work DescriptionHMA OVERLAY, REPLACE AC SURFACING, SHOULDER BACKING & TRAFFIC STRIPE.
Location DescriptionSISKIYOU COUNTY NEAR HAPPY CAMP FROM 0.1 MILE EAST OF OAK FLAT CREEK BRIDGE TO 0.1 MILE EAST OF BENJAMIN CREEK ROAD AND FROM 0.3 MILE WEST OF BEAVER CREEK BRIDGE TO 1.0 MILE WEST OF LUMGREY CREEK BRIDGE
QA Service Level1 (Verified on 10/30/2020)

Sample Information

Sample Taken Date06/07/2021 Sample Unique Key20
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 testing06/08/2021
Sample typeAcceptance A brief description of the samplePSE 1/2 Cold feed
The quantity of what the sample constitutes150 Tons From where was the sample collectedManufacturer
First name of sampler or witnessed byD. Last name of sampler or witnessed byOwens
Title of samplerPEI Telephone number of sampler
Laboratory sample identificationD78835 Linked DIME Sample ID2021-06-07-21
The fabricator/manufacturer/facility nameTullis Inc, Northstate Asphalt, Redding CA Transportation Laboratory (TL) Number779371
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)91-45-0057
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedSamplimg Device at Plant
Where the material sample would have been placed if not sampled02 SIS 96 Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-07-20-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Karen DoradoCT D02 - North Region Materials Lab06/08/2021Darrell Valasek
Yes
11/02/2021