Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2021-05-24-49
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Project Information
| Project Identifiers | Project ID: 215424 DEA: 024G4404 EFIS: 0214000013 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-3-38.0/38.6 |
| Award Date | 04/05/2021 |
| Closeout Date | 08/14/2023 |
| Work Description | BRIDGE REPLACEMENT |
| Location Description | SISKIYOU 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 Level | 1 (Verified on 01/19/2021) |
Sample Information
| Sample Taken Date | 05/24/2021 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 | 05/24/2021 |
| Sample type | Verification | A brief description of the sample | Sized Untreated 3/8" Virgin Aggregate |
| The quantity of what the sample constitutes | Verification of JMF 21-04-S01 | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Devin | Last name of sampler or witnessed by | Owens |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D78808B | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Tullis - Nortstate Asphalt, Redding, CA | Transportation Laboratory (TL) Number | 897297 |
| 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 | Sized Untreated Virgin Stockpile | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
| The concrete mix design number | JMF 21-04-S01 | Lot number | |
| Sublot number | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-64 | Date Created | 08/02/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2021-81 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | L210556 | Authorized Date | 08/13/2021 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-05-24-49-1 AASHTO T27-14 (Verified)