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: 2022-07-11-11
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Control
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 07/11/2022
Date that the sample was received by the laboratory/organization performing the testing: 07/11/2022
The quantity of what the sample constitutes: 24 Boxes
A brief description of the sample: 3/4 inch RHMA-G PG 64-16
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Syar Industries - Lake Herman
DIME Test ID: 2022-07-11-11-1
Test Method: ASTM D297-15: Standard Test Methods for Rubber Products - Chemical Analysis (Chemical Analysis)
Verified Date: 07/11/2022
Date Tested: 07/11/2022
Submitted By Organization: CT HQ - Sacramento Hot Mix Asphalt Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
General Comments for this Test: Submitted from JMF - James Brewster
Test Result Compliance:
Additional Comments When Verified:
|
CRM Type
|
High Natural
|
|
Natural rubber content in high natural CRM
|
41.9 %
|
