Sample Record

Owner Lab

  • CT D04 - Petaluma Field Laboratory

DIME Sample ID 2023-05-25-113

Project Information

Project IdentifiersProject ID: 993333
DEA: 04264724
EFIS: 0419000068
DIST-CO-RTE-PM04-MRN-101-R20.8/27.1
Award Date04/26/2022
Closeout DateNot set
Work DescriptionCIP BRIDGES, CONSTRUCT ROADWAY, RETAINING WALLS AND MODIFY ELECTRICAL.
Location DescriptionMARIN 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 Level1 (Verified on 11/01/2021)

Sample Information

Sample Taken Date05/25/2023 Sample Unique Key113
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 testing05/26/2023
Sample typeQuality Assurance A brief description of the sample3/4 HMA-SP Type A
The quantity of what the sample constitutes1 bag From where was the sample collectedManufacturer
First name of sampler or witnessed byAnthony Last name of sampler or witnessed byValdez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDutra Materials Richmond 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)91-21-0008
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 collectedConveyer Belt-HMA Plant
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size3/4 inch
The concrete mix design number Lot number5
Sublot number9 Aggregate Mix Number

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2023-05-25-113-1AASHTO T27-14: Standard Method of Test for Sieve Analysis of Fine and Coarse Aggregates (Sieve Analysis)Anthony Valdez, CT D04 - Petaluma Field Laboratory05/26/2023Anthony Valdez
Yes
02/07/2024
2023-05-25-113-2AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)Anthony Valdez, CT D04 - Petaluma Field Laboratory05/26/2023Anthony Valdez
Yes
02/07/2024

Sample File Attachments

File NameExtensionDate UploadedActions
SP_DrierDrum-23-298pdf02/07/2024   Info

Test File Attachments


DIME Test ID: 2023-05-25-113-1 AASHTO T27-14 (Verified)
DIME Test ID: 2023-05-25-113-2 AASHTO T176-08 (Verified)