Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-06-25-16

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 Date06/25/2021 Sample Unique Key16
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 testing06/30/2021
Sample typeAcceptance A brief description of the sample3/8 x No.8 PCC Aggregate
The quantity of what the sample constitutes2 Bags From where was the sample collectedManufacturer
First name of sampler or witnessed byDanny Last name of sampler or witnessed byHansen
Title of samplerConsultant Telephone number of sampler
Laboratory sample identificationD78872 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMoores Sand and Gravel Transportation Laboratory (TL) Number853079
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)91-47-0014
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 collectedStockpile
Where the material sample would have been placed if not sampled02 SIS 3 38 to 38 6 Primary Aggregate Nominal Size3/8 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
2021-06-25-16-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesTerry McCormickCT D02 - North Region Materials Lab06/30/2021Darrell Valasek
No
Info
2021-06-25-16-2CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing MachineTerry McCormickCT D02 - North Region Materials Lab06/30/2021Darrell Valasek
No
Info