Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-05-14-32

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215441
DEA: 021J5204
EFIS: 0220000087
DIST-CO-RTE-PM02-MOD,SIS-139-34.0/50.7,0.0/5.0
Award Date03/02/2021
Closeout Date09/27/2021
Work DescriptionPLACE ASPHALT RUBBER BINDER CHIP SEAL & REPLACE AC SURFACING.
Location DescriptionMODOC AND SISKIYOU COUNTIES AT AND NEAR NEWELL FROM 3.3 MILES NORTH OF PEREZ OVERHEAD TO ROUTE 161
QA Service Level1 (Verified on 02/01/2021)

Sample Information

Sample Taken Date05/14/2021 Sample Unique Key32
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 testing05/17/2021
Sample typeAcceptance A brief description of the sample3/8″ Chips for Use in ARB Chip Seal
The quantity of what the sample constitutesHalf-Day to Whole Project From where was the sample collectedSource
First name of sampler or witnessed byDanny Last name of sampler or witnessed byHansen
Title of sampler Telephone number of sampler
Laboratory sample identificationD78797 Linked DIME Sample ID
The fabricator/manufacturer/facility nameHat Creek Construction and Materials - Shaw Pit - Lookout, CA Transportation Laboratory (TL) Number897293
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)91-25-0008
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 collectedStockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-05-14-32-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesTerry McCormickCT D02 - North Region Materials Lab05/18/2021Ward Jenkins
Yes
07/22/2021
2021-05-14-32-2CTM 211-May 2010: Abrasion of Coarse Aggregate by Use of the Los Angeles Abrasion Testing MachineTerry McCormickCT D02 - North Region Materials Lab05/19/2021Ward Jenkins
Yes
07/22/2021
2021-05-14-32-3CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Terry McCormickCT D02 - North Region Materials Lab05/17/2021Ward Jenkins
Yes
07/22/2021
2021-05-14-32-4CTM 229-June 2011: Method of Test for Durability IndexTerry McCormickCT D02 - North Region Materials Lab05/19/2021Ward Jenkins
Yes
07/22/2021