Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2024-06-18-72

Project Information

Project IdentifiersProject ID: 994975
DEA: 034H0704
EFIS: 0318000158
DIST-CO-RTE-PM03-NEV-20-R12.2/20.0
Award Date10/26/2023
Closeout Date07/15/2025
Work DescriptionCOLD PLANE AND OVERLAY, INSTALL CURED-IN-PLACE PIPELINERS.
Location DescriptionNEVADA COUNTY IN AND NEAR GRASS VALLEY AND NEVADA CITY FROM ROUTE 20/49 SEPARATION TO 0.1 MILE EAST OF CELIO ROAD
QA Service Level1 (Verified on 08/28/2023)

Sample Information

Sample Taken Date06/18/2024 Sample Unique Key72
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 testing06/20/2024
Sample typeQuality Assurance A brief description of the sample3/4" RHMA-G-SP, PG 64-16
The quantity of what the sample constitutes1 Can From where was the sample collectedSource
First name of sampler or witnessed byMike Last name of sampler or witnessed byChittenden
Title of sampler Telephone number of sampler
Laboratory sample identification3811 Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert Hallwood Transportation Laboratory (TL) Number2024-06-18-108
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 number1
Sublot number4 Tank number
Time of sample HMA SupplierTeichert Hallwood
Certified Asphalt SupplierPacific Northwest Oil - Stockton CA MultigradeNo
Multigrade Type Asphalt Binder Mix Number

Submitted Tests

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