Sample Record
Owner Lab
- CT HQ - Sacramento Aggregate Testing Laboratory
DIME Sample ID 2021-11-09-49
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Project Information
| Project Identifiers | Project ID: 214114 DEA: 040A5394 EFIS: 0418000244 |
|---|---|
| DIST-CO-RTE-PM | 04-SOL-80,12-11.4/12.8, 2.1/2.8 |
| Award Date | Not set |
| Closeout Date | 02/24/2023 |
| Work Description | Widen EB SR-12 Connector, Construct 3 ramps & 2 box girder bridges, remove existing bridge, etc. |
| Location Description | I-80/I-680/Route 12 Interchange |
| QA Service Level | 1 (Verified on 04/23/2019) |
Sample Information
| Sample Taken Date | 11/09/2021 | Sample Unique Key | 49 |
|---|---|---|---|
| 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 testing | 12/21/2021 |
| Sample type | Annual Source Testing | A brief description of the sample | 1.5 Coarse Aggregate |
| The quantity of what the sample constitutes | 3-bags individual size | From where was the sample collected | Source |
| First name of sampler or witnessed by | Plant | Last name of sampler or witnessed by | Plant |
| Title of sampler | QC Lab | Telephone number of sampler | |
| Laboratory sample identification | 21-PCCC-0217 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Cemex Cache Creek Plant | Transportation Laboratory (TL) Number | C044055 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-57-0008 |
|---|---|---|---|
| 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 collected | Source | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1-1/2 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-11-09-49-1 CTM 214-August 2010 (Verified)