Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-02-11-5

Project Information

Project IdentifiersProject ID: 209511
DEA: 080Q7403
EFIS: 0800020456
DIST-CO-RTE-PM08-SBD-15-15.4/30.8
Award Date10/29/2013
Closeout DateNot set
Work DescriptionDesign Build project provides pavement rehabilitation (including ramps) on I-15 near Cajon Pass, CA.
Location DescriptionOn I-15 from 0.4 mile north of Kenwood Avenue to 0.3 mile south of West Hesperia OH
QA Service Level1 (Verified on 04/03/2014)

Sample Information

Sample Taken Date02/11/2015 Sample Unique Key5
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 testing02/12/2015
Sample typeAnnual Source Testing A brief description of the sampleWashed Concrete Sand
The quantity of what the sample constitutes2 bags From where was the sample collectedSource
First name of sampler or witnessed byJeff Last name of sampler or witnessed byLopez
Title of samplerQ C Manager Telephone number of samplerUnknown
Laboratory sample identification5022B Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameCemex Lytle Creek Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)SMARA No 91 36 0040
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedStockpiles
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Sizefine
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
2015-02-11-5-1CTM 202-November 2011: Method of Test for Sieve Analysis of Fine and Coarse AggregatesNemencio DaofCT - Southern Regional Laboratory02/17/2015Charles Mcdonald
No
Info
2015-02-11-5-2CTM 207-March 2012: Method of Test for Specific Gravity and Absorption of Fine AggregateNemencio DaofCT - Southern Regional Laboratory02/18/2015Charles Mcdonald
No
Info
2015-02-11-5-3CTM 213-December 2012: Method of Test for Organic Impurities in Concrete SandNader RashidiCT - Southern Regional Laboratory02/17/2015Charles Mcdonald
No
Info
2015-02-11-5-4CTM 217-June 2011: Method of Test for Sand EquivalentFarzin FarahCT - Southern Regional Laboratory02/17/2015Charles Mcdonald
No
Info
2015-02-11-5-5CTM 227-June 2012: Method of Test for Evaluating Cleanness of Coarse Aggregate (Cleanness)Nemencio DaofCT - Southern Regional Laboratory02/18/2015Charles Mcdonald
No
Info