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Sample Record for 2017-04-03-21

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 213793 DEA: 060W7004 EFIS: 0617000283 QA Service Level: 1
DIST-CO-RTE-PM: 06-FRE-33-24.3/R29.0,R39.9/44.5
Work Description: COLD PLANE AC PAVEMENT, PLACE HMA RESURFACING.
Location Description: FRESNO COUNTY ABOUT 7.8 MILES NORTH OF COALINGA FROM NORTH JUNCTION ROUTE 198 TO SOUTH JUNCTION ROUTE 33/5 AND FROM 0.1 MILE NORTH OF NORTH JUNCTION ROUTE 33/5 TO EL PROGRESSIO ROAD
Contractor Name: PAPICH CONSTRUCTION COMPANY, INC.
Contractor Address: 398 SUNRISE TERRACE, ARROYO GRANDE CA 93420
Resident Engineer: Michael Stavropoulos Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2017-04-03-21
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Hot Mix Asphalt Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Quality Control
Type of Material: Antistrip Additive
Sample Taken Date: 04/03/2017
Date that the sample was received by the laboratory/organization performing the testing: 04/03/2017
The quantity of what the sample constitutes: JMF HMA Design Data (Dispute Resolution)
A brief description of the sample: LAS XL-9000 (Dispute Resolution)
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Road Science

Material Information

Antistrip Type: LAS - liquid antistrip

Test Results

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.