Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-05-17-42

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212496
DEA: 024E4504
EFIS: 0200020286
DIST-CO-RTE-PM02-LAS,MOD-139,299-VAR
Award Date07/28/2020
Closeout DateNot set
Work DescriptionPLACE HMA, REPLACE DRAINAGE, CULVERT, ELECTRICAL AND LIGHTING SYSTEMS.
Location DescriptionLASSEN AND MODOC COUNTIES ON ROUTE 139 AT 0.1 MILE NORTH OF LASSEN COUNTY LINE AND ON ROUTE 299 AT VARIOUS LOCATONS FROM 0.4 MILE WEST OF BOYD HILL LOOKOUT ROAD TO 0.6 MILE EAST OF COUNTY ROAD 87
QA Service Level1 (Verified on 06/06/2017)

Sample Information

Sample Taken Date05/17/2021 Sample Unique Key42
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 testing05/18/2021
Sample typeAcceptance A brief description of the sample3/4-inch Type A Treated Virgin Aggregate
The quantity of what the sample constitutes750 Tons From where was the sample collectedManufacturer
First name of sampler or witnessed byEmilio Last name of sampler or witnessed byChavez
Title of sampler Telephone number of sampler
Laboratory sample identificationD78800A Linked DIME Sample ID
The fabricator/manufacturer/facility nameHat Creek Construction and Materials - Shaw Pit Facility - Lookout, CA Transportation Laboratory (TL) Number766427
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 collectedCold Feed
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design numberJMF 21-03-002 Lot number1
Sublot number7 HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-05-17-42-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Terry McCormickCT D02 - North Region Materials Lab05/19/2021Ward Jenkins
Yes
07/22/2021