Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2023-02-10-47
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215486 DEA: 040A0204 EFIS: 0400000129 |
|---|---|
| DIST-CO-RTE-PM | 04-SON-1-15-15.7 |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Construct roadway and bridge with structural concrete and CIDH piling |
| Location Description | District-County-Route-Post Mile: 04-Son-1-R15.0/R15.7 |
| QA Service Level | 1 (Verified on 04/08/2022) |
Sample Information
| Sample Taken Date | 02/10/2023 | Sample Unique Key | 47 |
|---|---|---|---|
| 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 | 02/10/2023 |
| Sample type | Quality Assurance | A brief description of the sample | HMA Aggregates |
| The quantity of what the sample constitutes | 4 Bags | From where was the sample collected | Source |
| First name of sampler or witnessed by | Anthony | Last name of sampler or witnessed by | Valdez |
| Title of sampler | Consultant | Telephone number of sampler | 916-837-3760 |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | BoDean Santa Rosa | Transportation Laboratory (TL) Number | 861615 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | 1 | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-49-0032 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | 700-SPW-16 | The fabricator/manufacturer designation for the sample | |
| The plant number | A detailed description of where the material sample was collected | Pulled from Bin 2 | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/8 inch | |
| The concrete mix design number | Lot number | 1 | |
| Sublot number | 1 | Aggregate Mix Number |
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. | |||