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Sample Record for 2021-12-20-20

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

Project Information

Project ID: 44444 DEA: ASCP EFIS: ASCP QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-12-20-20
TL Number from the TL Form:
Sample Submitted By Organization: Albina Asphalt
Sample Organization Contact: (503) 539-3830
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 12/20/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/20/2021
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Tank 1
From where was the sample collected: Manufacturer
Laboratory sample identification: PG6416122021T1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Chowchilla, CA

Material Information

Performance Grade: PG 64-16
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Albina Asphalt
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
Test results on following page(s): 2

Test Results

Test 1 of 2

DIME Test ID: 2021-12-20-20-1
Test Method: AASHTO T316-17: Standard Method of Test for Viscosity Determination of Asphalt Binder Using Rotational Viscometer
Submitted By Organization: Albina Asphalt
Organization Address: 801 Main Street,
Organization City: Vancouver
Organization State: WA
Organization Zipcode: 98686
Organization Email: keven.heitschmidt@albina.com
Organization Phone: (503) 539-3830
Data has not been verified.

Test 2 of 2

DIME Test ID: 2021-12-20-20-2
Test Method: AASHTO T315-20: Standard Method of Test for Determining the Rheological Properties of Asphalt Binder Using a Dynamic Shear Rheometer (DSR) (Dynamic Shear)
Submitted By Organization: Albina Asphalt
Organization Address: 801 Main Street,
Organization City: Vancouver
Organization State: WA
Organization Zipcode: 98686
Organization Email: keven.heitschmidt@albina.com
Organization Phone: (503) 539-3830
Data has not been verified.