Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-10-04-33

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215403
DEA: 021H4004
EFIS: 0216000042
DIST-CO-RTE-PM02-SIS-5-R8.3
Award Date03/02/2021
Closeout DateNot set
Work DescriptionPLACE STRUCTURAL CONCRETE BRIDGE DECK AND BARRIER AND PLACE HMA.
Location DescriptionSISKIYOU COUNTY NEAR MOUNT SHASTA AT AZALEA ROAD OVERCROSSING
QA Service Level1 (Verified on 01/07/2021)

Sample Information

Sample Taken Date10/04/2021 Sample Unique Key33
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 testing10/05/2021
Sample typeAcceptance A brief description of the sample3/4" Class II AB
The quantity of what the sample constitutes2 bags From where was the sample collectedManufacturer
First name of sampler or witnessed byKarl Last name of sampler or witnessed byHuntman
Title of samplerJET Telephone number of sampler
Laboratory sample identificationD78946 Linked DIME Sample ID
The fabricator/manufacturer/facility nameMountain Gate Quarry Transportation Laboratory (TL) Number853080
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)91-45-0001
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 collectedStockpile
Where the material sample would have been placed if not sampled02 SIS 5 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
2021-10-04-33-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesTerry McCormickCT D02 - North Region Materials Lab10/06/2021Darrell Valasek
Yes
10/15/2021
2021-10-04-33-2CTM 217-June 2011: Method of Test for Sand EquivalentTerry McCormickCT D02 - North Region Materials Lab10/06/2021Darrell Valasek
Yes
10/15/2021
2021-10-04-33-3CTM 229-June 2011: Method of Test for Durability IndexTerry McCormickCT D02 - North Region Materials Lab10/06/2021Darrell Valasek
Yes
10/15/2021
2021-10-04-33-4CTM 301-March 2000: Method for Determining the Resistance "R" Value of Treated and Untreated Bases, Subbases, and Basement Soils by the StabilometerTerry McCormickCT D02 - North Region Materials Lab10/09/2021Darrell Valasek
Yes
10/15/2021