Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2023-03-08-20

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 Date03/08/2023 Sample Unique Key20
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 testing03/08/2023
Sample typeQuality Assurance A brief description of the sample3/4 HMA-SP Type A
The quantity of what the sample constitutes1 bag From where was the sample collectedSupplier
First name of sampler or witnessed byJose Last name of sampler or witnessed byRoman
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameBodean - Santa Rosa Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-49-0032
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 collectedConveyor Belt
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number
Sublot number Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-03-08-20-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Jose Ibarra-Roman, CT D04 - Petaluma Field Laboratory03/08/2023Jose Ibarra-Roman
Yes
03/22/2023Bin # 2

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2023-03-08-20-1 AASHTO T27-14 (Verified)