Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2022-12-22-69
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 993333 DEA: 04264724 EFIS: 0419000068 |
|---|---|
| DIST-CO-RTE-PM | 04-MRN-101-R20.8/27.1 |
| Award Date | 04/26/2022 |
| Closeout Date | Not set |
| Work Description | CIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL. |
| Location Description | MARIN 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 Level | 1 (Verified on 11/01/2021) |
Sample Information
| Sample Taken Date | 12/22/2022 | Sample Unique Key | 69 |
|---|---|---|---|
| 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 | 12/22/2022 |
| Sample type | Annual Source Testing | A brief description of the sample | WCS PCC Aggregate |
| The quantity of what the sample constitutes | 2 bags | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Anthony | Last name of sampler or witnessed by | Valdez |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Mark West Quarry | Transportation Laboratory (TL) Number | |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | 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 | The fabricator/manufacturer designation for the sample | ||
| The plant number | A detailed description of where the material sample was collected | Mark West Quarry | |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2022-12-22-69-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2022-12-22-69-2 CTM 217-June 2011 (Verified)
DIME Test ID: 2022-12-22-69-3 CTM 226-July 2010 (Verified)