Sample Record

Owner Lab

  • CT D05 - Santa Maria Field Laboratory

DIME Sample ID 2023-11-17-8

Project Information

Project IdentifiersProject ID: 215336
DEA: 051G9804
EFIS: 0516000009
DIST-CO-RTE-PM05-SLO-1-10.0/16.8
Award Date12/19/2022
Closeout DateNot set
Work DescriptionRHMA (GAP GRADED), RETAINING WALL, CURB RAMPS AND LIGHTING SYSTEMS.
Location DescriptionSAN LUIS OBISPO COUNTY FROM GRACIA WAY AT OCEANO TO ROUTE 1/101 SEPARATION IN PISMO BEACH.
QA Service Level1 (Verified on 11/18/2020)

Sample Information

Sample Taken Date11/17/2023 Sample Unique Key8
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 testing11/17/2023
Sample typeAcceptance A brief description of the sample3/4" Recycled class 2 AB
The quantity of what the sample constitutes750 From where was the sample collectedJob Site
First name of sampler or witnessed byIsaac Last name of sampler or witnessed byGleffe
Title of sampler Telephone number of sampler18053191237
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameCalportland-Garey Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA, name of Pit or Job Site)91-42-0014
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 collectedStockpile on Jobsit
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number1
Sublot number2 Aggregate Mix Number911

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Test File Attachments