Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-08-30-30

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215393
DEA: 021J5104
EFIS: 0220000086
DIST-CO-RTE-PM02-LAS,MOD-139-57.0/66.635,0.0/0.1
Award Date02/10/2021
Closeout Date11/24/2021
Work DescriptionPERFORM COLD IN-PLACE RECYCLING AND PLACE HOT MIX ASPHALT (TYPE A).
Location DescriptionLASSEN AND MODOC COUNTIES NEAR ADIN FROM 4.5 MILES SOUTH OF COUNTY ROAD A2 TO 0.1 MILE SOUTH OF ROUTE 299
QA Service Level1 (Verified on 01/07/2021)

Sample Information

Sample Taken Date08/30/2021 Sample Unique Key30
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 testing08/31/2021
Sample typeAcceptance A brief description of the sample1/2 inch combined lime treated coldfeed and RAP
The quantity of what the sample constitutesPSE at 286 Tons From where was the sample collectedManufacturer
First name of sampler or witnessed byE. Last name of sampler or witnessed byChavez
Title of samplerMaterials Tester Telephone number of sampler
Laboratory sample identificationD78933 Linked DIME Sample ID2021-08-30-28, 2021-08-30-29
The fabricator/manufacturer/facility nameHat Creek Construction and Materials - Shaw Pit Facility - Lookout, CA Transportation Laboratory (TL) Number848954
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 collectedPlant Sampler
Where the material sample would have been placed if not sampled02 LAS MOD 139 Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot numberUnknown
Sublot numberUnknown HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-08-30-30-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Darrell ValasekCT D02 - North Region Materials Lab09/01/2021Darrell Valasek
Yes
09/09/2021