Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2023-01-26-101
Project Information
Project Identifiers | Project ID: 993776 DEA: 040J3004 EFIS: 0413000433 |
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DIST-CO-RTE-PM | 04-SON-1-26.7/27.1 |
Award Date | 07/08/2022 |
Closeout Date | Not set |
Work Description | CONSTRUCTING RETAINING WALL AND CONFINEMENT SYSTEM TO RESTORE SLIPOUT. |
Location Description | SONOMA COUNTY NEAR JENNER FROM 0.3 MILE TO 0.7 MILE NORTH OF MEYERS GRADE ROAD |
QA Service Level | 1 (Verified on 05/11/2022) |
Sample Information
Sample Taken Date | 01/26/2023 | Sample Unique Key | 101 |
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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 | 01/26/2023 |
Sample type | Annual Source Testing | A brief description of the sample | 3/8 inch PCC Aggregate |
The quantity of what the sample constitutes | 6 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 | Syar Healdsburg | 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) | 91-49-0030 |
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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 | Syar Healdsburg | |
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 | ||
Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |
Test File Attachments
DIME Test ID: 2023-01-26-101-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2023-01-26-101-2 CTM 227-December 2014 (Verified)