Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2026-06-22-8

Project Information

Project IdentifiersProject ID: 1001564
DEA: 030J4104
EFIS: 0319000281
DIST-CO-RTE-PM03-PLA-80-33.0/44.9
Award Date07/01/2025
Closeout DateNot set
Work DescriptionCOLD PLANE AC PVMT, HMA, CLASS 2 AB, RDWY EXC, MGS, & RCP.
Location DescriptionPLACER COUNTY IN AND NEAR COLFAX FROM 0.1 MILE WEST OF ROUTE 174/80 SEPARATION TO 0.1 MILE EAST OF ALTA ROAD UNDERCROSSING
QA Service Level1 (Verified on 09/17/2025)

Sample Information

Sample Taken Date06/22/2026 Sample Unique Key8
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing06/22/2026
Sample typeQuality Assurance A brief description of the samplePG 58-22
The quantity of what the sample constitutes1 Can From where was the sample collectedManufacturer
First name of sampler or witnessed byDustan Last name of sampler or witnessed byKliethermes
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility namePNW Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name Bid ItemNot set

Material Information

Material TypeAsphalt Binder Performance GradePG 58-22
ModifiedNo Lot number1
Sublot number3 Tank number
Time of sample HMA SupplierTeichert Hallwood
Certified Asphalt SupplierPacific Northwest Oil - Stockton CA MultigradeNo
Multigrade Type Asphalt Binder Mix Number30940132416P

Submitted Tests

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