Sample Record

Owner Lab

  • CT D07 Plant Services

DIME Sample ID 2022-06-17-28

Project Information

Project IdentifiersProject ID: 215364
DEA: 07333204
EFIS: 0716000301
DIST-CO-RTE-PM07-LA-5-.8/.8
Award Date09/08/2021
Closeout DateNot set
Work DescriptionINSTALL SOLAR PV POWERED LIGHTING SYSTEM.
Location DescriptionIN KERN COUNTY NEAR LEBEC AT VARIOUS LOCATIONS FROM OFF-RAMP OF NORTHBOUND REST AREA TO 0.1 MILE NORTH OF OFF-RAMP OF SOUTHBOUND REST AREA.
QA Service Level1 (Verified on 07/12/2021)

Sample Information

Sample Taken Date06/17/2022 Sample Unique Key28
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 testing06/20/2022
Sample typeQuality Assurance A brief description of the sample1x4 Aggregates
The quantity of what the sample constitutes40 CY From where was the sample collectedSupplier
First name of sampler or witnessed bySeifu Last name of sampler or witnessed byMersha
Title of sampler Telephone number of sampler12132164406
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameALPINE READY MIX Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-15-0041
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 collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberCTCL1717 Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2022-06-17-28-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesSeifu MershaCT D07 Plant Services06/21/2022Seifu Mersha
Yes
07/06/2022
2022-06-17-28-3CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Seifu MershaCT D07 Plant Services06/21/2022Seifu Mersha
Yes
07/06/2022
2022-06-17-28-4CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesSeifu MershaCT D07 Plant Services06/21/2022Seifu Mersha
Yes
07/06/2022
2022-06-17-28-6CTM 227-December 2014: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Seifu MershaCT D07 Plant Services06/22/2022Seifu Mersha
Yes
07/01/2022