Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2023-02-10-50
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 | 50 |
|---|---|---|---|
| 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 | 3/4 HMA |
| The quantity of what the sample constitutes | 2 boxes | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Cody | Last name of sampler or witnessed by | Brown |
| Title of sampler | Inspector | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Bodean - Santa Rosa | Transportation Laboratory (TL) Number | 101340 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
|---|---|---|---|
| HMA Grading | 3/4 inch | Lot number | 1 |
| Sublot number | 1 | HMA Mix Number | D04 JMF 22 011 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2023-02-10-50-2 AASHTO T209-12 (Verified)