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

Sample Record for 2019-11-12-9


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: 2019-11-12-9
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: 11/12/2019
Date that the sample was received by the laboratory/organization performing the testing:
The quantity of what the sample constitutes: JMF4 bags
A brief description of the sample: for JMF QC
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: Hot Drop at the Plant
Where the material sample would have been placed if not sampled:
Primary Aggregate Nominal Size: 1/2 inch
The concrete mix design number:
Lot number:
Sublot number:

Test Results

Test Information 6 of 8

DIME Test ID: 2019-11-12-9-6
Test Method: CTM 204-June 2010: Method of Test for Liquid Limit, Plastic Limit and Plasticity Index of Soils (Plasticity Index)
Verified Date: 11/12/2019
Date Tested: 11/12/2019
Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Blvd
Test General Comments:
Additional Comments When Verified:
Plastic Index(PI) 0
Liquid Limit (LL) 0 %
Plastic Limit (PL) 0 %