Sample Record

Owner Lab

  • CT HQ - Sacramento Asphalt Binder Laboratory

DIME Sample ID 2023-01-16-3

Project Information

Project IdentifiersProject ID: 66669
DEA: JMF-DATA
EFIS: JMF-DATA
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for storing JMF sample data
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date01/16/2023 Sample Unique Key3
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 testing06/19/2023
Sample typeVerification A brief description of the samplePG 64-10
The quantity of what the sample constitutes2 Bage From where was the sample collectedSource
First name of sampler or witnessed byWasil Ahmad Last name of sampler or witnessed byMobariz
Title of samplerNot set Telephone number of samplerNot set
Laboratory sample identificationNot set Linked DIME Sample IDNot set
The fabricator/manufacturer/facility nameDeer Creek Asphalt Transportation Laboratory (TL) NumberNot set
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeCrumb Rubber Modifier CRM TypeScrap Tire
Crumb Rubber Modifier Mix NumberNot set

JMF Information

Verification IDJMF3513-2023-51 Date Created11/09/2023
JMF Submittal IDJMF3511-201-2023-58 JMF StatusSubmittal Authorized For Use
Producer Mix ID23-1011.263-0.5inchPG64-10 Authorized Date11/16/2023

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