Sample Record

DIME Sample ID 2021-09-07-20

Project Information

Project IdentifiersProject ID: 215393
DEA: 021J5104
EFIS: 0220000086
DIST-CO-RTE-PM02-LAS,MOD-139-57.0/66.635,0.0/0.1
Award Date02/10/2021
Closeout Date11/24/2021
Work DescriptionPERFORM COLD IN-PLACE RECYCLING AND PLACE HOT MIX ASPHALT (TYPE A).
Location DescriptionLASSEN AND MODOC COUNTIES NEAR ADIN FROM 4.5 MILES SOUTH OF COUNTY ROAD A2 TO 0.1 MILE SOUTH OF ROUTE 299
QA Service Level1 (Verified on 01/07/2021)

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

Sample Information

Sample Taken Date09/07/2021 Sample Unique Key20
Date that the sample was received by the laboratory/organization performing the testing09/20/2021 Sample typeDepartment Acceptance
A brief description of the sample58-34M The quantity of what the sample constitutes1 can
From where was the sample collectedSource First name of sampler or witnessed byE
Last name of sampler or witnessed byCHAVEZ Title of samplerMATLS
Telephone number of sampler Laboratory sample identification
Linked DIME Sample ID The fabricator/manufacturer/facility nameKLAMATH FALLS, OR
Transportation Laboratory (TL) Numberc848966 Inspector Lot Number from the Transportation Laboratory (TL) Form
Structure unique identifier Structure name
Bid ItemNot set

Material Information

Material TypeAsphalt Binder Performance GradePG 58-34 M
ModifiedYes Lot number
Sublot number Tank number
Time of sample HMA SupplierCONTRACTOR HAT CREEK
Certified Asphalt SupplierAlbina Asphalt - Klamath Falls Plant - Klamath Falls OR MultigradeNo
Multigrade Type Asphalt Binder Mix NumberNot set
HMA TypeNot set HMA Supplier Mix ID NumberNot set

Submitted Tests

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