Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2014-11-13-4

Project Information

Project IdentifiersProject ID: 7463
DEA: 042640U4
EFIS: 0412000195
DIST-CO-RTE-PM04-SON-101-0.9/3.6
Award Date11/01/2012
Closeout Date06/03/2020
Work DescriptionCONSTRUCT PETALUMA BLVD SOUTH INTERCHANGE, REPLACE PETALUMA RIVER BR
Location DescriptionSONOMA COUNTY IN AND NEAR PETALUMA FROM GUNN DRIVE TO ROUTE 101/116 SEPARATION AND OVERHEAD
QA Service Level1 (Verified on 09/11/2012)

Sample Information

Sample Taken Date11/13/2014 Sample Unique Key4
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 testing01/23/2015
Sample typeAnnual Source Testing A brief description of the samplePCC Aggregate
The quantity of what the sample constitutes1 From where was the sample collectedSource
First name of sampler or witnessed byQC Last name of sampler or witnessed byQC
Title of samplerQC Telephone number of samplerUnknown
Laboratory sample identification15-0046 9736-60C Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameSyar Lake Herman Transportation Laboratory (TL) NumberC917848
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-48-0002
The fabricator's/manufacturer's product name for the sampleone and a half inch The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpile
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2014-11-13-4-1CTM 214-August 2010: Method of Test for Soundness of Aggregates by Use of Sodium SulfateEd PerezCT HQ - Sacramento Aggregate Testing Laboratory02/06/2015Ed Perez
Yes
02/10/2015