Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2021-06-23-52
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Project Information
| Project Identifiers | Project ID: 215367 DEA: 021J4904 EFIS: 0220000084 |
|---|---|
| DIST-CO-RTE-PM | 02-TEH-32-14.0/20.0 |
| Award Date | 02/02/2021 |
| Closeout Date | 04/11/2024 |
| Work Description | PLACE HOT MIX ASPHALT (TYPE A). |
| Location Description | TEHAMA COUNTY ABOUT 28 MILES EAST OF FOREST RANCH FROM 1.1 MILES EAST OF DEER CREEK BRIDGE NO. 08-0068 TO 0.4 MILE WEST OF SLATE CREEK BRIDGE NO. 08-0154 |
| QA Service Level | 1 (Verified on 12/24/2020) |
Sample Information
| Sample Taken Date | 06/23/2021 | Sample Unique Key | 52 |
|---|---|---|---|
| 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 | 06/24/2021 |
| Sample type | Verification | A brief description of the sample | Combined Treated Virgin Aggregate for use in 3/8-inch Type A HMA |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Derek | Last name of sampler or witnessed by | Serna |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D78855A | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Sierra Cascade Aggregate and Asphalt Products | Transportation Laboratory (TL) Number | 896906 |
| 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) | 91-32-0002::Chester Pit 1 |
|---|---|---|---|
| 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 | Cold Feed | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2022-1 | Date Created | 02/01/2022 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2022-1 | JMF Status | Submittal Accepted for Verification |
| Producer Mix ID | L200669 | Authorized Date | N/A |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2021-06-23-52-1 AASHTO T27-14 (Verified)