Sample Record

Owner Lab

  • CT D01 - Eureka Field Laboratory

DIME Sample ID 2022-06-21-48

Project Information

Project IdentifiersProject ID: 993468
DEA: 010C1104
EFIS: 0112000229
DIST-CO-RTE-PM01-HUM-101-60.4
Award DateNot set
Closeout DateNot set
Work DescriptionConstruct New Materials Lab
Location DescriptionHUMBOLDT COUNTY IN FORTUNA AT THE MATERIALS LABORATORY AT 1050 RIVER RANCH ROAD
QA Service Level1 (Verified on 12/28/2021)

Sample Information

Sample Taken Date06/21/2022 Sample Unique Key48
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 testing06/22/2022
Sample typePreliminary A brief description of the sampleCoarse PCC Aggregate
The quantity of what the sample constitutesPeliminary data From where was the sample collectedSource
First name of sampler or witnessed byJ Thomas Last name of sampler or witnessed byWoodhead
Title of sampler Telephone number of sampler
Laboratory sample identification22-293, 294, 295 Linked DIME Sample ID2022-06-21-43, 2022-06-21-44, 2022-06-21-45
The fabricator/manufacturer/facility nameMercer Fraser Fortuna 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)91-12-0002
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 collectedStockpile
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1 inch
The concrete mix design numberMF CL 2 Salg Lot number
Sublot number HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments