Sample Record

Owner Lab

  • CT - Southern Regional Laboratory

DIME Sample ID 2015-11-12-3

Project Information

Project IdentifiersProject ID: 208714
DEA: 08043514
EFIS: 0800000010
DIST-CO-RTE-PM08-SBD-58-R22.2/R31.1
Award Date12/30/2014
Closeout Date08/29/2018
Work DescriptionREALIGN AND WIDEN 2 TO 4 LANES EXPRESSWAY
Location DescriptionHINKLEY ROAD FROM 2.4 MILES WEST OF HIDDEN RIVER ROAD TO? 0.7 MILE EAST OF LENWOOD ROAD.
QA Service Level1 (Verified on 03/22/2013)

Sample Information

Sample Taken Date11/12/2015 Sample Unique Key3
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 testing11/13/2015
Sample typeAcceptance A brief description of the sampleClass 2 Aggregate Base for Roadway fill
The quantity of what the sample constitutes2 Bags From where was the sample collectedSource
First name of sampler or witnessed byLarry Last name of sampler or witnessed byFrancisco
Title of samplerTE Telephone number of samplerUnknown
Laboratory sample identification5292B Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameBest Rock Borrow Pit Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)Unknown
The fabricator's/manufacturer's product name for the sampleUnknown The fabricator/manufacturer designation for the sampleUnknown
The plant numberUnknown A detailed description of where the material sample was collectedBest Rock Borrow Pit
Where the material sample would have been placed if not sampledUnknown Primary Aggregate Nominal Size
The concrete mix design number Lot numberNot set
Sublot numberNot set HMA Design ID

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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