Sample Record

DIME Sample ID 2021-04-12-68

Project Information

Project IdentifiersProject ID: 215033
DEA: 033H6504
EFIS: 0318000027
DIST-CO-RTE-PM03-NEV-49-8.3/8.7
Award Date08/07/2020
Closeout Date09/23/2021
Work DescriptionCONSTRUCT A TWO-WAY LEFT-TURN LANE AND 8' SHOULDERS.
Location DescriptionNEVADA COUNTY ON ROUTE 49 FROM 0.1 MILE SOUTH OF ROUND VALLEY ROAD TO 0.1 MILE NORTH OF QUAIL CREEK DRIVE
QA Service Level1 (Verified on 06/22/2020)

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

Sample Information

Sample Taken Date04/12/2021 Sample Unique Key68
Date that the sample was received by the laboratory/organization performing the testing04/13/2021 Sample typeVerification
A brief description of the samplePG 64-16 Asphalt Binder The quantity of what the sample constitutes3 cans
From where was the sample collectedDistributor First name of sampler or witnessed byKRC Personnel (SAMPLER)
Last name of sampler or witnessed byThao Xiong (WITNESS) Title of samplerUnknown
Telephone number of samplerUnknown Laboratory sample identificationJMF21-022
Linked DIME Sample ID The fabricator/manufacturer/facility nameKnife River Construction - Hallwood
Transportation Laboratory (TL) NumberC779131 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
ModifiedYes Lot number
Sublot number Tank numberUnknown
Time of sampleUnknown HMA SupplierKnife River Construction - Hallwood
Certified Asphalt SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type Asphalt Binder Mix NumberNot set
HMA TypeNot set HMA Supplier Mix ID NumberNot set

JMF Information

Verification IDJMF3513-2021-62 Date Created06/21/2021
JMF Submittal IDJMF3511-23-2021-79 JMF StatusSubmittal Authorized For Use
Producer Mix IDHR-22771000V Authorized Date09/10/2021

Submitted Tests

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