Sample Record

DIME Sample ID 2021-06-04-20

Project Information

Project IdentifiersProject ID: 215626
DEA: 032G1504
EFIS: 0320000234
DIST-CO-RTE-PM03-PLA-193-3.0/10.1
Award Date05/11/2021
Closeout Date11/29/2021
Work DescriptionCOLD PLANE AC PAVEMENT & RHMA OVERLAY.
Location DescriptionPLACER COUNTY NEAR LINCOLN FROM SIERRA COLLEGE BOULEVARD TO OPHIR ROAD
QA Service Level1 (Verified on 03/29/2021)

Owner Lab

  • CT D03 - Olivehurst Northern Regional Laboratory

Sample Information

Sample Taken Date06/04/2021 Sample Unique Key20
Date that the sample was received by the laboratory/organization performing the testing06/22/2021 Sample typeVerification
A brief description of the samplePG64-16 Asphalt Binder The quantity of what the sample constitutes3 cans
From where was the sample collectedSupplier First name of sampler or witnessed byMack
Last name of sampler or witnessed byAbbott Title of sampler
Telephone number of sampler Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameTeichart-Hallwood Drum Plant
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 64-16
Modified Lot number
Sublot number Tank number
Time of sample HMA Supplier
Certified Asphalt SupplierMarathon Petroleum Co. LP - Elk Grove CA MultigradeNo
Multigrade Type Asphalt Binder Mix NumberNot set
HMA TypeNot set HMA Supplier Mix ID NumberNot set

JMF Information

Verification IDJMF3513-2021-65 Date Created08/03/2021
JMF Submittal IDJMF3511-23-2021-83 JMF StatusSubmittal Authorized For Use
Producer Mix ID309-40542500-M Authorized Date07/26/2021

Submitted Tests

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