Sample Record

Owner Lab

  • CT D01 - District 1 Materials Laboratory

DIME Sample ID 2024-05-29-25

Project Information

Project IdentifiersProject ID: 994856
DEA: 010H5604
EFIS: 0117000236
DIST-CO-RTE-PM01-HUM-299-0.0/R5.7
Award Date08/07/2023
Closeout DateNot set
Work DescriptionPLACE RHMA, REPLACE ASPHALT CONCRETE, AND CONCRETE BARRIER TRANSITION.
Location DescriptionHUMBOLDT COUNTY IN AND NEAR ARCATA FROM ROUTE 299/101 SEPARATION TO 0.2 MILE EAST OF BLUE LAKE UNDERCROSSING
QA Service Level1 (Verified on 06/08/2023)

Sample Information

Sample Taken Date05/29/2024 Sample Unique Key25
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing05/30/2024
Sample typeAcceptance A brief description of the sample1 can PG 64-16 binder
The quantity of what the sample constitutes1 can binder From where was the sample collectedSource
First name of sampler or witnessed byAngela Last name of sampler or witnessed byCook
Title of samplerConsultant Tester Telephone number of sampler
Laboratory sample identification24-086 Linked DIME Sample ID
The fabricator/manufacturer/facility nameKernen Blue Lake Plant Transportation Laboratory (TL) Number972381
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA Supplier
Certified Asphalt SupplierVSS Emutech - Redding CA MultigradeNo
Multigrade Type Asphalt Binder Mix Number

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