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Sample Record for 2021-03-08-7

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

Project Information

Project ID: 99999 DEA: 0322222 QA Service Level:
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME TESTERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-03-08-7
TL Number from the TL Form:
Sample Submitted By Organization: Veleroo - Coolidge
Sample Organization Contact: 111-111-1111
Type of Sample: Quality Control
Type of Material: Asphalt Binder
Sample Taken Date: 03/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 03/07/2021
The quantity of what the sample constitutes: 1
A brief description of the sample: 1
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: 1

Material Information

Performance Grade: PG 58-34 M
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Asphalt Binder Supplier: Valero Coolidge - Coolidge AZ
Multigrade:
Multigrade Type:

Test Results

Test 1 of 4

DIME Test ID: 2021-03-08-7-1
Test Method: AASHTO T301-13: Standard Method of Test for Elastic Recovery Test of Asphalt Materials by Means of a Ductilometer
Verified Date: 03/30/2021
Date Tested: 04/01/2021
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc St,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email:
Organization Phone: 111-111-1111
General Comments for this Test: test
Test Result Compliance:
Additional Comments When Verified:
% Elongation Recovery 33 %

Test 2 of 4

DIME Test ID: 2021-03-08-7-2
Test Method: AASHTO T240-17: Standard Method of Test for Effect of Heat and Air on a Moving Film of Asphalt Binder (Rolling Thin-Film Oven Test)
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc St,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email:
Organization Phone: 111-111-1111
Data has not been verified.

Test 3 of 4

DIME Test ID: 2021-03-08-7-3
Test Method: AASHTO T51-13: Standard Method of Test for Ductility of Asphalt Materials (Asphalt Binder)
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc St,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email:
Organization Phone: 111-111-1111
Data has not been verified.

Test 4 of 4

DIME Test ID: 2021-03-08-7-4
Test Method: AASHTO T301-13: Standard Method of Test for Elastic Recovery Test of Asphalt Materials by Means of a Ductilometer
Submitted By Organization: Veleroo - Coolidge
Organization Address: 123 Abc St,
Organization City: Coolidge
Organization State: AZ
Organization Zipcode: 88888
Organization Email:
Organization Phone: 111-111-1111
Data has not been verified.

Tests Assigned to this Sample

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