*Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Sample Record for 2019-10-01-25


Project Information

Project ID: 66667 DEA: JMFPP EFIS: 0019000043 QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Contractor Address:
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2019-10-01-25
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 10/01/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: 1
A brief description of the sample: 3/4 inch HMA-SP RAP WMA
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:

Material Information

Source Identification (SMARA or name of Pit): 91-48-0002::LAKE HERMAN QUARRY
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: Stockpile @ 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:

Test Results

Test Information 5 of 9

DIME Test ID: 2019-10-01-25-5
Test Method: AASHTO T176-08: Standard Method of Test for Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test (Sand Equivalent)
Verified Date: 10/11/2019
Date Tested: 10/01/2019
Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Blvd
Test General Comments: Aggregate quality sample 3/4inch sand equivalent T-176
Additional Comments When Verified:
Sand Equivalent 57