Sample Record

Owner Lab

  • Blackburn Consulting

DIME Sample ID 2024-07-21-10

Project Information

Project IdentifiersProject ID: 994975
DEA: 034H0704
EFIS: 0318000158
DIST-CO-RTE-PM03-NEV-20-R12.2/20.0
Award Date10/30/2023
Closeout DateNot set
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 Date07/21/2024 Sample Unique Key10
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 testing07/22/2024
Sample typeQuality Assurance A brief description of the sample3/4" RHMA-G-SP, PG 64-16
The quantity of what the sample constitutes2 Boxes 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 identification3954 Linked DIME Sample ID
The fabricator/manufacturer/facility nameTeichert Hallwood Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeRHMA-G
HMA Grading3/4 inch Lot number2
Sublot number7 HMA Mix Number

Submitted Tests

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