Sample Record

Owner Lab

  • CT D07 Plant Services

DIME Sample ID 2022-01-13-7

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 215042
DEA: 100TST04
EFIS: 1020999999
DIST-CO-RTE-PM10-STA-5-26.1/27.0
Award DateNot set
Closeout DateNot set
Work DescriptionThis is just a test EA, not tied to an actual project at all. Don't believe anything you read.
Location DescriptionNot set
QA Service Level1 (Verified on 06/29/2020)

Sample Information

Sample Taken Date01/13/2022 Sample Unique Key7
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 testing01/13/2022
Sample typeQuality Assurance A brief description of the sample1 x 4 PCC Aggregate
The quantity of what the sample constitutes100 cy From where was the sample collectedOther
First name of sampler or witnessed byAvo Last name of sampler or witnessed byKarajian
Title of samplerTET Telephone number of sampler213-798-6076
Laboratory sample identification111111 Linked DIME Sample ID2022-01-13-1
The fabricator/manufacturer/facility nameSECURITY PAVING - LA MIRADA Transportation Laboratory (TL) Number12345
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)91-03-0011
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number123 A detailed description of where the material sample was collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberG3-15-STR-006F Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-01-13-7-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesAvo KarajianCT D07 Plant Services01/13/2022Avo Karajian
Yes
02/17/2022