Sample Record
Owner Lab
- CT D05 - Carpinteria Field Laboratory
DIME Sample ID 2023-01-17-12
Project Information
Project Identifiers | Project ID: 215753 DEA: 050N72U4 EFIS: 0520000169 |
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DIST-CO-RTE-PM | 05-SB-101-4.4/R7.7 |
Award Date | 03/01/2021 |
Closeout Date | Not set |
Work Description | Please cc Office Engineer Ni Nyoman Paul on reports sent to RE and SR. Construct High Occupancy Vehicle (HOV) lanes on U.S. Route 101 and rehabilitation - Segment 4B. |
Location Description | 101 freeway in Summerland, CA |
QA Service Level | 1 (Verified on 05/06/2021) |
Sample Information
Sample Taken Date | 01/17/2023 | Sample Unique Key | 12 |
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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 | 01/17/2023 |
Sample type | Quality Assurance | A brief description of the sample | CRCP Aggregates |
The quantity of what the sample constitutes | 1200 cy | From where was the sample collected | Supplier |
First name of sampler or witnessed by | Dorell | Last name of sampler or witnessed by | Harper |
Title of sampler | Telephone number of sampler | 6692889248 | |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Granite Portable plant | 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) | 91-42-0006 |
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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 | Conveyor Belt | |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
The concrete mix design number | G3-20-PCC-231 | Lot number | |
Sublot number | Aggregate Mix Number |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2023-01-17-12-1 CTM 217-June 2011 (Verified)