Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-06-11-20

Project Information

Project IdentifiersProject ID: 215424
DEA: 024G4404
EFIS: 0214000013
DIST-CO-RTE-PM02-SIS-3-38.0/38.6
Award Date03/22/2021
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU COUNTY ABOUT 6 MILES NORTH OF FORT JONES FROM 0.3 MILE SOUTH TO 0.3 MILE NORTH OF LOWER MOFFETT CREEK ROAD
QA Service Level1 (Verified on 01/19/2021)

Sample Information

Sample Taken Date06/11/2021 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 testing06/14/2021
Sample typeAcceptance A brief description of the sampleShoulder Backing
The quantity of what the sample constitutes2 Bags From where was the sample collectedJob Site
First name of sampler or witnessed byChad Last name of sampler or witnessed byEnsminger
Title of samplerARE Telephone number of sampler
Laboratory sample identificationD78842 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMontague Pit Transportation Laboratory (TL) Number850979
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)Montague Pit
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 collectedIn Place 0.2 ft 2-SIS-3-pm38 to 38.6
Where the material sample would have been placed if not sampledShoulder 02 SIS 3 38 to 38 6 Primary Aggregate Nominal Size1-1/2 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
2021-06-11-20-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesTerry McCormickCT D02 - North Region Materials Lab06/15/2021Darrell Valasek
No
Info
2021-06-11-20-2CTM 217-June 2011: Method of Test for Sand EquivalentColt SweenyCT D02 - North Region Materials Lab06/16/2021Darrell Valasek
No
Info
2021-06-11-20-3CTM 229-June 2011: Method of Test for Durability IndexColt SweenyCT D02 - North Region Materials Lab06/16/2021Darrell Valasek
No
Info