Sample Taken Date	09/16/2024	Sample Unique Key	64
Date that the sample was received by the laboratory/organization performing the testing	09/20/2024	Sample type	Verification
A brief description of the sample	JMF Verification	The quantity of what the sample constitutes	1 OF 1
From where was the sample collected	Source	First name of sampler or witnessed by	A.
Last name of sampler or witnessed by	Cook	Title of sampler
Telephone number of sampler		Laboratory sample identification
Linked DIME Sample ID		The fabricator/manufacturer/facility name	Kerman Plant, Blue Lake
Transportation Laboratory (TL) Number		Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier		Structure name
Bid Item	Not set

Material Type	Asphalt Binder	Performance Grade	PG 64-28 M
Modified	Yes	Lot number
Sublot number		Tank number
Time of sample		HMA Supplier	Granite Kernan Plant
Certified Asphalt Supplier	Valero Marketing & Supply - Benicia CA	Multigrade	No
Multigrade Type		Asphalt Binder Mix Number
HMA Type	Not set	HMA Supplier Mix ID Number	Not set

DIME Test ID: 2024-09-16-64-1 AASHTO T315-22 (Verified)
DIME Test ID: 2024-09-16-64-5 AASHTO T301-22 (Verified)
DIME Test ID: 2024-09-16-64-6 AASHTO T315-22 (Verified)
DIME Test ID: 2024-09-16-64-7 AASHTO T315-22 (Verified)