Sample Record

DIME Sample ID 2021-03-19-26

Project Information

Project IdentifiersProject ID: 215405
DEA: 032G1604
EFIS: 0320000235
DIST-CO-RTE-PM03-YOL-45-0.6/12.9
Award Date02/16/2021
Closeout Date06/30/2021
Work DescriptionCOLD PLANE AC PAVEMENT AND REPLACE WITH HOT MIX ASPHALT.
Location DescriptionYOLO COUNTY NEAR KNIGHTS LANDING FROM SYCAMORE SLOUGH BRIDGE TO YOLO COUNTY LINE ROAD
QA Service Level1 (Verified on 01/18/2021)

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

Sample Information

Sample Taken Date03/19/2021 Sample Unique Key26
Date that the sample was received by the laboratory/organization performing the testing03/19/2021 Sample typeVerification
A brief description of the sampleAsphalt Binder PG 64-16 The quantity of what the sample constitutesJMF Verification
From where was the sample collectedManufacturer First name of sampler or witnessed byTeichert Personnel (SAMPLER)
Last name of sampler or witnessed bySam Mosallem (WITNESS) Title of sampler
Telephone number of sampler Laboratory sample identificationJMF21-015
Linked DIME Sample ID The fabricator/manufacturer/facility nameTeichert - Woodland Plant
Transportation Laboratory (TL) NumberC849138 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA SupplierTeichert - Woodland Plant
Certified Asphalt SupplierMarathon Petroleum Co. LP - Elk Grove CA MultigradeNo
Multigrade TypeNot set Asphalt Binder Mix NumberNot set
HMA TypeNot set HMA Supplier Mix ID NumberNot set

JMF Information

Verification IDJMF3513-2021-51 Date Created05/24/2021
JMF Submittal IDJMF3511-23-2021-63 JMF StatusSubmittal Authorized For Use
Producer Mix ID40332407 Authorized Date09/10/2021

Submitted Tests

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