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Sample Record for 2021-02-16-36

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

Project Information

Project ID: 214515 DEA: 024F6004 EFIS: 0213000012 QA Service Level: 1
DIST-CO-RTE-PM: 02-SIS,TRI-36,96,299-VAR
Work Description: BRIDGE DECK REPAIR, POLYESTER OVERLAY AND RAIL REPLACEMENT.
Location Description: SISKIYOU AND TRINITY COUNTIES AT VARIOUS LOCATIONS
Contractor Name: MYERS AND SONS CONSTRUCTION
Contractor Address: 4600 NORTHGATE BLVD, STE #100, SACRAMENTO, CA 95834
Resident Engineer: Sunil Repaka Structure Rep.: Thompson, Robert

Sample Information

DIME Sample ID: 2021-02-16-36
TL Number from the TL Form: 815632
Sample Submitted By Organization: CT D02 - North Region Materials Lab
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 02/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 02/16/2021
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: PG 64-28 M
From where was the sample collected: Manufacturer
Laboratory sample identification: D78746
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero - Benicia, CA

Material Information

Performance Grade: PG 64-28 M
Modified: Yes
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: Mercer-Fraser Company – Willow Creek Plant (Willow Creek, CA)
Asphalt Binder Supplier: Valero Marketing & Supply - Benicia CA
Multigrade:

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.