Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
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
DIME Sample ID: 2021-12-27-6
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: 12/27/2021
Date that the sample was received by the laboratory/organization performing the testing: 12/27/2021
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: PG6416122721T1
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Chowchilla, CA
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:
DIME Test ID: 2021-12-27-6-1
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.
DIME Test ID: 2021-12-27-6-2
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.
