Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66669 DEA: JMF-DATA EFIS: JMF-DATA
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for storing JMF sample data
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2025-12-16-15
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Sample Organization Contact: (562) 500-5861
Type of Sample: Quality Control
Type of Material: Asphalt Binder
Sample Taken Date: 12/16/2025
Date that the sample was received by the laboratory/organization performing the testing: 12/16/2025
The quantity of what the sample constitutes: rrr
A brief description of the sample: fdff
From where was the sample collected: Fabricator
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: rrr
Performance Grade: PG 58-22
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Albina Asphalt (Klamath Falls Plant) - Klamath Falls OR
Multigrade: Yes
Multigrade Type:
Asphalt Binder Mix Number:
DIME Test ID: 2025-12-16-15-1
Test Method: AASHTO T228-09r13: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)
Submitted By Organization: CT HQ - Sacramento Materials Management Branch Field Office
Organization Address: 5900 Folsom Boulevard, MS 5,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: brett.soldano@dot.ca.gov
Organization Phone: (562) 500-5861
Data has not been verified.
