Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2023-02-13-64

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN COUNTY IN AND NEAR NOVATO FROM 0.1 MILE SOUTH OF FRANKLIN AVENUE OVERHEAD TO 0.5 MILE SOUTH OF SAN ANTONIO CREEK BRIDGE
QA Service Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date02/13/2023 Sample Unique Key64
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 testing02/14/2023
Sample typeVerification A brief description of the samplehalf inch HMA Type A
The quantity of what the sample constitutes1 bag From where was the sample collectedFabricator
First name of sampler or witnessed bya Last name of sampler or witnessed byv
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDutra Richmond 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)91-49-0008
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 collectedCombined Hot Bins
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 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
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Sample File Attachments

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Test File Attachments