Sample Record

Owner Lab

  • CT HQ - FFS - Skid Testing

DIME Sample ID 2024-07-22-48

Project Information

Project IdentifiersProject ID: 1000075
DEA: 010L9504
EFIS: 0122000067
DIST-CO-RTE-PM01-HUM-101,255-VAR
Award Date05/03/2024
Closeout DateNot set
Work DescriptionPOLYESTER CONCRETE OVERLAY, HMA-A, & COLD PLANE ASPHALT CONCRETE.
Location DescriptionHUMBOLDT COUNTY AT VARIOUS LOCATIONS
QA Service Level1 (Verified on 02/05/2024)

Sample Information

Sample Taken Date07/22/2024 Sample Unique Key48
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 testing07/22/2024
Sample typeQuality Assurance A brief description of the samplePortable Skid Test
The quantity of what the sample constitutesSkid Testing From where was the sample collectedJob Site
First name of sampler or witnessed byJessie Last name of sampler or witnessed byWilson
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameJob Site Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure nameKing Salmon Ave + others

Material Information

Material TypeRoadway/Bridge Surface Pavement Surface TypeMethacrylate Resin
Type of Traffic Control ProvidedN/A DIST-CO-RTE
Direction of Travel Post Mile
Lanes to be Tested Station

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