Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-04-23-22

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 Date04/23/2021 Sample Unique Key22
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 testing04/23/2021
Sample typeVerification A brief description of the sampleDust Sized Untreated Aggregate
The quantity of what the sample constitutesJMF Verification From where was the sample collectedSource
First name of sampler or witnessed byDevin Last name of sampler or witnessed byOwens
Title of samplerPEI Telephone number of sampler
Laboratory sample identificationD78785C Linked DIME Sample ID
The fabricator/manufacturer/facility nameShasta Ranch Aggregates - Anderson, CA Transportation Laboratory (TL) Number858622
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 sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedSized Untreated Stockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Sizefine
The concrete mix design numberJMF 21-05-S01 Lot number
Sublot number JMF Verification ID JMF3513-2021-61

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-04-23-22-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab04/27/2021Ward Jenkins
Yes
06/22/2021
2021-04-23-22-2AASHTO T104-99r16: Standard Method of Test for Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate (Soundness)Bang NguyenCT HQ - Sacramento Aggregate Testing Laboratory07/22/2021Bang Nguyen
Yes
07/22/2021