Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2022-03-17-23
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 66667 DEA: JMFPP EFIS: 0019000043 |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for submitting Sample information for JMF Prequalification Program. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 03/17/2022 | Sample Unique Key | 23 |
|---|---|---|---|
| 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 | 03/21/2022 |
| Sample type | Annual Source Testing | A brief description of the sample | 3 bags of Untreated 3/8″ Sized Virgin Aggregate for use in 3/4-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 | Cindy | Last name of sampler or witnessed by | Bryant |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | D79009B | Linked DIME Sample ID | 2022-03-17-25 |
| The fabricator/manufacturer/facility name | Tullis – Northstate Asphalt (Redding, CA) | Transportation Laboratory (TL) Number | 708110 |
| 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) | 91-45-0057::Shasta Ranch Aggregates |
|---|---|---|---|
| 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 | Sized Untreated Aggregate Stockpile | |
| 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 | JMF3513-2022-2 | Date Created | 03/21/2022 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2022-3 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | L220310 | Authorized Date | 05/24/2022 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-03-17-23-1 AASHTO T27-14 (Verified)
DIME Test ID: 2022-03-17-23-2 AASHTO T104-99r16 (Verified)