Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2021-11-03-41

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215424
DEA: 024G4404
EFIS: 0214000013
DIST-CO-RTE-PM02-SIS-3-38.0/38.6
Award Date03/22/2021
Closeout DateNot set
Work DescriptionBRIDGE REPLACEMENT
Location DescriptionSISKIYOU 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 Level1 (Verified on 01/19/2021)

Sample Information

Sample Taken Date11/03/2021 Sample Unique Key41
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 testing11/04/2021
Sample typeAcceptance A brief description of the sampleShoulder Backing
The quantity of what the sample constitutesUp to 3000 tons From where was the sample collectedManufacturer
First name of sampler or witnessed byKarl Last name of sampler or witnessed byHoutman
Title of samplerJET Telephone number of sampler
Laboratory sample identificationD78975 Linked DIME Sample ID
The fabricator/manufacturer/facility nameCustom Crushing Inc Transportation Laboratory (TL) Number853089
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)custom crushing
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 sampled Primary Aggregate Nominal Size1-1/2 inch
The concrete mix design number Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2021-11-03-41-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesDarrell ValasekCT D02 - North Region Materials Lab11/24/2021Darrell Valasek
Yes
11/29/2021
2021-11-03-41-2CTM 229-June 2011: Method of Test for Durability IndexColt SweenyCT D02 - North Region Materials Lab11/29/2021Darrell Valasek
Yes
11/29/2021
2021-11-03-41-3CTM 217-June 2011: Method of Test for Sand EquivalentKaren DoradoCT D02 - North Region Materials Lab11/20/2021Darrell Valasek
Yes
11/29/2021
2021-11-03-41-4CTM 205-December 2010: Method of Test for Determining Percentage of Crushed ParticlesKaren DoradoCT D02 - North Region Materials Lab11/20/2021Darrell Valasek
Yes
11/29/2021Percentage of coarse, 1 and 2 fractured faced, crushed particles was determined. The percentage of fine crushed particles was not determined.