Sample Record
Owner Lab
- CT D09 - Bishop Field Laboratory
DIME Sample ID 2023-08-31-27
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 213404 DEA: 120Q3404 EFIS: 1216000130 Permit Numbers: 1217NMC0723 1218NDP0423 1218NRT0056 |
|---|---|
| DIST-CO-RTE-PM | 12-ORA-241-13.1/16.7 |
| Award Date | 01/03/2018 |
| Closeout Date | 08/19/2021 |
| Work Description | Construct the Oso PWY bridge and extend SR-241 to connect to Los Patrones PKW. in the County of Orange. Two lanes will be constructed of HMA in each direction on SR-241. Oso Parkway N/B on-ramp and S/B off-ramp gores will be modified to connect to new mainline pavement. improve new overhead signs, |
| Location Description | OSO PARKWAY INTERCHANGE, COUNTY OF ORANGE |
| QA Service Level | 2 (Verified on 06/05/2018) |
Sample Information
| Sample Taken Date | 08/31/2023 | Sample Unique Key | 27 |
|---|---|---|---|
| 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 | 08/31/2023 |
| Sample type | Verification | A brief description of the sample | 3/4" HMA Coldfeed & RAP |
| The quantity of what the sample constitutes | 1 Bag of Coldfeed & 1 Bag of RAP | From where was the sample collected | Source |
| First name of sampler or witnessed by | Jerid | Last name of sampler or witnessed by | Kupelian |
| Title of sampler | Consultant | Telephone number of sampler | |
| Laboratory sample identification | JMF 2 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Fisher Sand & Gravel | 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) | 00-00-0000 |
|---|---|---|---|
| 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 | Sampled from Belt Cut at Hot Plant | |
| 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 | ||
| Sublot number | Aggregate Mix Number |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||