Sample Record
Owner Lab
- CT D01 - District 1 Materials Laboratory
DIME Sample ID 2022-06-21-48
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Project Information
| Project Identifiers | Project ID: 993468 DEA: 010C1104 EFIS: 0112000229 |
|---|---|
| DIST-CO-RTE-PM | 01-HUM-101-60.4 |
| Award Date | 03/17/2022 |
| Closeout Date | Not set |
| Work Description | Construct New Materials Lab |
| Location Description | HUMBOLDT COUNTY IN FORTUNA AT THE MATERIALS LABORATORY AT 1050 RIVER RANCH ROAD |
| QA Service Level | 1 (Verified on 12/28/2021) |
Sample Information
| Sample Taken Date | 06/21/2022 | Sample Unique Key | 48 |
|---|---|---|---|
| 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 | 06/22/2022 |
| Sample type | Preliminary | A brief description of the sample | Coarse PCC Aggregate |
| The quantity of what the sample constitutes | Peliminary data | From where was the sample collected | Source |
| First name of sampler or witnessed by | J Thomas | Last name of sampler or witnessed by | Woodhead |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | 22-293, 294, 295 | Linked DIME Sample ID | 2022-06-21-43, 2022-06-21-44, 2022-06-21-45 |
| The fabricator/manufacturer/facility name | Mercer Fraser Fortuna | Transportation Laboratory (TL) Number | |
| 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) | 91-12-0002 |
|---|---|---|---|
| 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 collected | Stockpile | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 1 inch | |
| The concrete mix design number | MF CL 2 Salg | Lot number | |
| Sublot number | Aggregate Mix Number | Not set |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||