Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2021-06-14-55
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Project Information
| Project Identifiers | Project ID: 215250 DEA: 021J4404 EFIS: 0220000079 |
|---|---|
| DIST-CO-RTE-PM | 02-MOD-299-20.0/23.1,23.5/24.5,33.5/37.5 |
| Award Date | 12/14/2020 |
| Closeout Date | 09/27/2021 |
| Work Description | ASPHALT RUBBER CHIP SEAL. |
| Location Description | MODOC COUNTY AT VARIOUS LOCATIONS FROM 1.8 MILES WEST OF ROUTE 139 TO 0.3 MILE WEST OF RATTLESNAKE CREEK BRIDGE |
| QA Service Level | 1 (Verified on 10/30/2020) |
Sample Information
| Sample Taken Date | 06/14/2021 | Sample Unique Key | 55 |
|---|---|---|---|
| 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 | 06/22/2021 |
| Sample type | Department Acceptance | A brief description of the sample | 1 bag of Sand for Cover (Seal) |
| The quantity of what the sample constitutes | Project | From where was the sample collected | Other |
| First name of sampler or witnessed by | Cindy | Last name of sampler or witnessed by | Bryant |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | D78853 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Eagle Peak Rock and Paving, Alturas, CA | Transportation Laboratory (TL) Number | 853349 |
| 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) | Eagle Peak |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Unknown | The fabricator/manufacturer designation for the sample | Unknown |
| The plant number | Unknown | A detailed description of where the material sample was collected | Unknown |
| Where the material sample would have been placed if not sampled | 02 MOD 299 | Primary Aggregate Nominal Size | fine |
| The concrete mix design number | Not Applicable | Lot number | Unknown |
| Sublot number | Unknown | 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: 2021-06-14-55-1 CTM 202-November 2011 (Verified)