Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2021-04-23-24
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Project Information
| Project Identifiers | Project ID: 215251 DEA: 021J4604 EFIS: 0220000081 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-96-34.5/38.8,88.0/92.0 |
| Award Date | 02/02/2021 |
| Closeout Date | 09/27/2021 |
| Work Description | HMA OVERLAY, REPLACE AC SURFACING, SHOULDER BACKING & TRAFFIC STRIPE. |
| Location Description | SISKIYOU 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 Level | 1 (Verified on 10/30/2020) |
Sample Information
| Sample Taken Date | 04/23/2021 | Sample Unique Key | 24 |
|---|---|---|---|
| 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 testing | 04/23/2021 |
| Sample type | Verification | A brief description of the sample | 1/2-inch Type A Treated Virgin Aggregate |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Source |
| First name of sampler or witnessed by | Devin | Last name of sampler or witnessed by | Owens |
| Title of sampler | PEI | Telephone number of sampler | |
| Laboratory sample identification | D78784A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Northstate Asphalt - Redding, CA | Transportation Laboratory (TL) Number | 897290 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 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 collected | Cold Feed | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1/2 inch | |
| The concrete mix design number | JMF 21-05-S01 | Lot number | |
| Sublot number | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-61 | Date Created | 06/18/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2021-78 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | L210154 | Authorized Date | 07/06/2021 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-04-23-24-1 AASHTO T27-14 (Verified)