Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2023-02-10-29

Project Information

Project IdentifiersProject ID: 215486
DEA: 040A0204
EFIS: 0400000129
DIST-CO-RTE-PM04-SON-1-15-15.7
Award DateNot set
Closeout DateNot set
Work DescriptionConstruct roadway and bridge with structural concrete and CIDH piling
Location DescriptionDistrict-County-Route-Post Mile: 04-Son-1-R15.0/R15.7
QA Service Level1 (Verified on 04/08/2022)

Sample Information

Sample Taken Date02/10/2023 Sample Unique Key29
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 testing02/10/2023
Sample typeQuality Assurance A brief description of the sample Aggregates
The quantity of what the sample constitutes4 bags per bin From where was the sample collectedSupplier
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameBodean - Santa Rosa Transportation Laboratory (TL) Number861612
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number1
Sublot number1 HMA Mix NumberD04 JMF 22 011

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments