Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-06-21-17

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 Date06/21/2021 Sample Unique Key17
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 testing06/21/2021
Sample typeAcceptance A brief description of the sample3 bags of Combined Lime Treated Virgin 3/8-inch Aggregate from Cold Feed for use in 3/8-inch Type A HMA
The quantity of what the sample constitutesProduction Start-Up Evaluation From where was the sample collectedManufacturer
First name of sampler or witnessed byDevin Last name of sampler or witnessed byOwens
Title of samplerPEI Telephone number of sampler
Laboratory sample identificationD78848A Linked DIME Sample ID2021-06-21-18
The fabricator/manufacturer/facility nameTullis Inc - Northstate Asphalt - Redding, CA Transportation Laboratory (TL) Number853076
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifier
Structure nameNot Applicable

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-45-0057::Shasta Ranch Aggregates
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 collectedSampling Belt
Where the material sample would have been placed if not sampled02 SIS 96 Primary Aggregate Nominal Size3/8 inch
The concrete mix design numberNot Applicable Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-06-21-17-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab06/22/2021Darrell Valasek
Yes
01/20/2022