Sample Record

Owner Lab

  • CT HQ - Sacramento Concrete Testing Laboratory

DIME Sample ID 2014-12-12-3

Project Information

Project IdentifiersProject ID: 209135
DEA: 04235844
EFIS: 0400000684
COOP: 042493
DIST-CO-RTE-PM04-SM-101-16.3/17.06
Award Date06/25/2014
Closeout Date12/17/2019
Work DescriptionRECONSTRUCT OVERCROSSING, RETAINING WALLS, GROUND IMPROVEMENT,
Location DescriptionBURLINGAME
QA Service Level1 (Verified on 10/03/2013)

Sample Information

Sample Taken Date12/12/2014 Sample Unique Key3
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 sampleConcrete Blend Sand
The quantity of what the sample constitutes1 From where was the sample collectedSource
First name of sampler or witnessed byGreg Last name of sampler or witnessed byWilkinson
Title of samplerQC Telephone number of samplerUnknown
Laboratory sample identification15-0050 6808-14C Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameGranite Quail Hollow Felton Transportation Laboratory (TL) NumberC911215
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)91-44-0007
The fabricator's/manufacturer's product name for the sampleQuail Hollow The fabricator/manufacturer designation for the sampleBlend Sand
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
2014-12-12-3-1CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandEd PerezCT HQ - Sacramento Aggregate Testing Laboratory01/30/2015Ed Perez
Yes
02/10/2015