Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 214136 DEA: 010F3604 EFIS: 0115000115
QA Service Level: 1
DIST-CO-RTE-PM: 01-HUM-101-R39.2/R48.3
Work Description: COLD PLANE AC PAVEMENT, RHMA OVERLAY, AND GUARDRAIL INSTALLATION.
Location Description: HUMBOLDT COUNTY NEAR REDCREST, PEPPERWOOD, AND STAFFORD FROM ENGLWOOD PARK UNDERCROSSING TO EEL RIVER BRIDGE AND OVERHEAD
Contractor Name: MERCER-FRASER COMPANY
Contractor Address: PO BOX 1006, EUREKA CA 95502
Resident Engineer: Joaquin Rodriguez Structure Rep.: Unknown
DIME Sample ID: 2019-10-29-52
TL Number from the TL Form:
Sample Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Sample Organization Contact: (559) 292-2188
Type of Sample: Quality Control
Type of Material: Crumb Rubber Modifier
Sample Taken Date: 10/29/2019
Date that the sample was received by the laboratory/organization performing the testing: 10/29/2019
The quantity of what the sample constitutes: JMF
A brief description of the sample: 1/2" RHMA-G
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Mercer Fraser B
DIME Test ID: 2019-10-29-52-1
Test Method: CTM 385-November 2016: Method of Test for Sampling and Testing Crumb Rubber Modifier (CRM)
Verified Date: 10/30/2019
Date Tested: 10/30/2019
Submitted By Organization: Trinity Engineering Laboratories, Incorporated - Fresno
Organization Address: 2473 North Sunnyside Avenue,
Organization City: Fresno
Organization State: CA
Organization Zipcode: 93727
Organization Email: mhorn@trinityeng.co
Organization Phone: (559) 260-6841
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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CRM Gradation Type
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Scrap Tire
|
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Scrap Tire CRM gradation (% passing No. 8 sieve)
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100 %
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Wire in CRM
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0 %
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Fabric in CRM
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0 %
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