Sample Record
Owner Lab
- CT D04 - Petaluma Field Laboratory
DIME Sample ID 2023-04-17-66
Project Information
Project Identifiers | Project ID: 993333 DEA: 04264724 EFIS: 0419000068 |
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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 | 04/17/2023 | Sample Unique Key | 66 |
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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 | 04/17/2023 |
Sample type | Quality Assurance | A brief description of the sample | 3/4 HMA-SP Type A |
The quantity of what the sample constitutes | 1 bag | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Jose | Last name of sampler or witnessed by | Roman |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Dutra San Rafael | 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) | 91-21-0008 |
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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 | HMA Plant Cold Feed Conveyor | |
Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | 3/4 inch | |
The concrete mix design number | Lot number | 4 | |
Sublot number | 15 | 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: 2023-04-17-66-1 AASHTO T27-14 (Verified)
DIME Test ID: 2023-04-17-66-2 AASHTO T176-08 (Verified)