Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-06-10-28

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 Date06/10/2021 Sample Unique Key28
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 testing06/10/2021
Sample typeAcceptance A brief description of the sampleColdfeed Lime Treated 3/4" Agg
The quantity of what the sample constitutesPSE 2 bags coldfeed at 150 Tons From where was the sample collectedManufacturer
First name of sampler or witnessed byDerrick Last name of sampler or witnessed byCurry
Title of samplerCGI Telephone number of sampler
Laboratory sample identificationD78839 Linked DIME Sample ID2021-06-10-29
The fabricator/manufacturer/facility nameJ F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA Transportation Laboratory (TL) Number779375
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)91-45-0017
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 SHA SIS 5 Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberUnknown Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-10-28-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/14/2021Darrell Valasek
No
Info