Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-09-01-26

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 Date09/01/2021 Sample Unique Key26
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 testing09/02/2021
Sample typeAcceptance A brief description of the sample3/4 inch combined lime treated coldfeed and RAP
The quantity of what the sample constitutesPSE 3 bags at 418 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 identificationD78937 Linked DIME Sample ID2021-09-01-24, 2021-09-01-25
The fabricator/manufacturer/facility nameHat Creek Construction and Materials - Shaw Pit Facility - Lookout, CA Transportation Laboratory (TL) Number848960
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 139 299 VAR Primary Aggregate Nominal Size3/4 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
2021-09-01-26-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Darrell ValasekCT D02 - North Region Materials Lab09/08/2021Darrell Valasek
Yes
09/09/2021