Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-08-25-4

Project Information

Project IdentifiersProject ID: 213469
DEA: 024C40V4
EFIS: 0218000125
DIST-CO-RTE-PM02-SHA-5-R3.8/R11.7
Award Date11/06/2018
Closeout DateNot set
Work DescriptionWIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB
Location DescriptionSHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING
QA Service Level1 (Verified on 12/31/2018)

Sample Information

Sample Taken Date08/25/2021 Sample Unique Key4
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 testing08/25/2021
Sample typeAcceptance A brief description of the sample3/8 inch Virgin Aggregate
The quantity of what the sample constitutes2 Bags for 100k Ton Milestone From where was the sample collectedManufacturer
First name of sampler or witnessed byJD Last name of sampler or witnessed byAtkinson
Title of samplerMaterials Tester Telephone number of sampler
Laboratory sample identificationD78930 Linked DIME Sample ID
The fabricator/manufacturer/facility nameJ F Shea Construction Inc - Fawndale Rock and Asphalt - Redding CA Transportation Laboratory (TL) Number858989
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)91-45-0017
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 at the Plant
Where the material sample would have been placed if not sampled02 SHA 5 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
2021-08-25-4-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Karen DoradoCT D02 - North Region Materials Lab08/26/2021Darrell Valasek
No
Info