Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2025-07-28-3

Project Information

Project IdentifiersProject ID: 66669
DEA: JMF-DATA
EFIS: JMF-DATA
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for storing JMF sample data
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date07/28/2025 Sample Unique Key3
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing07/03/2025
Sample typeVerification A brief description of the sample1
The quantity of what the sample constitutes1 From where was the sample collectedSource
First name of sampler or witnessed byMichael Last name of sampler or witnessed byMaksimovich
Title of samplerNot set Telephone number of samplerNot set
Laboratory sample identificationNot set Linked DIME Sample IDNot set
The fabricator/manufacturer/facility name1 Transportation Laboratory (TL) NumberNot set
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set Bid ItemNot set

Material Information

Material TypeAsphalt Rubber Binder Asphalt modifier supplierNot set
Performance GradePG 64-16 Lot numberNot set
Sublot numberNot set Asphalt Rubber Binder Mix NumberNot set

JMF Information

Verification IDJMF3513-2025-39 Date Created07/10/2025
JMF Submittal IDJMF3511-6-2025-40 JMF StatusSubmittal Accepted for Verification
Producer Mix IDtest123 Authorized DateN/A

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedDate AddedVerified?Release DateTest CommentsPrivacy LevelActions
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