Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2022-03-17-24
Project Information
Project Identifiers | Project ID: 66667 DEA: JMFPP EFIS: 0019000043 |
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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 | 24 |
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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 | 2 bags of Untreated Dust 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 | D79009C | 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 |
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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 | fine | |
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 |
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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 |
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No results found. |
Test File Attachments
DIME Test ID: 2022-03-17-24-2 AASHTO T104-99r16 (Verified)
DIME Test ID: 2022-03-17-24-3 AASHTO T27-14 (Verified)