Sample Record
Owner Lab
- CT D07 - Plant Services
DIME Sample ID 2024-04-01-24
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Project Information
| Project Identifiers | Project ID: 994648 DEA: 070W3904 EFIS: 0722000045 |
|---|---|
| DIST-CO-RTE-PM | 07-VEN-101-10.7/26.7 |
| Award Date | 06/20/2023 |
| Closeout Date | Not set |
| Work Description | SLURRY SEAL. |
| Location Description | VENTURA COUNTY FROM CAMARILLO SPRINGS ROAD UNDERCROSSING IN CAMARILLO TO MAIN STREET UNDERCROSSING IN VENTURA |
| QA Service Level | 1 (Verified on 07/24/2023) |
Sample Information
| Sample Taken Date | 04/01/2024 | Sample Unique Key | 24 |
|---|---|---|---|
| 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 | 04/01/2024 |
| Sample type | Acceptance | A brief description of the sample | Aggregate Type III for Slurry Seal |
| The quantity of what the sample constitutes | 300 Tons | From where was the sample collected | Job Site |
| First name of sampler or witnessed by | Kevin | Last name of sampler or witnessed by | Hopkins |
| Title of sampler | Plant Inspector | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Intermountain Slurry Seal Inc | Transportation Laboratory (TL) Number | C040124A |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | KH201A | Structure unique identifier | |
| Structure name |
Material Information
| Material Type | Aggregate | Source Identification (SMARA, name of Pit or Job Site) | 91-19-0046 |
|---|---|---|---|
| The fabricator's/manufacturer's product name for the sample | Type III Slurry Seal | The fabricator/manufacturer designation for the sample | |
| The plant number | Intermountain Slurry Seal Inc | A detailed description of where the material sample was collected | Stockpile @ Yard |
| Where the material sample would have been placed if not sampled | Primary Aggregate Nominal Size | fine | |
| The concrete mix design number | Lot number | ||
| Sublot number | Aggregate Mix Number |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2024-04-01-24-1 CTM 202-November 2011 (Verified)
DIME Test ID: 2024-04-01-24-2 CTM 217-June 2011 (Verified)