Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2021-09-08-19

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)

Sample Information

Sample Taken Date09/08/2021 Sample Unique Key19
Will the laboratory/organization for which you are a member perform testing on this material sample?Yes Date that the sample was received by the laboratory/organization performing the testing09/08/2021
Sample typeDepartment Acceptance A brief description of the sampleTack
The quantity of what the sample constitutes1 jug From where was the sample collectedJob Site
First name of sampler or witnessed byJ Last name of sampler or witnessed byD
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameAlbina Transportation Laboratory (TL) Numberc858995
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphaltic Emulsion Emulsion GradeCQS-1
Lot NumberNot set Sub LotNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments