Print Report | Back to Sample Detail

Sample Record for 2021-03-05-22

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

Project Information

Project ID: 214492 DEA: 033F5404 EFIS: 0313000136 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC-99,160-4.5/5.7,R44.5
Work Description: FURNISH PRECAST PRESTRESSED CONCRETE SLAB & PLACE STRUCTURAL CONCRETE.
Location Description: SACRAMENTO COUNTY NEAR GALT ON ROUTE 99 FROM NORTH OF MINGO ROAD TO SOUTH OF ARNO ROAD OVERCROSSING AND IN SACRAMENTO ON ROUTE 160 AT AMERICAN RIVER BRIDGE
Contractor Name: BROSAMER & WALL, INC.
Contractor Address: 5000 Marsh Drive, Suite 300, Conord, CA 94520
Resident Engineer: Mohssen Ghassemi Structure Rep.: Chris Quon

Sample Information

DIME Sample ID: 2021-03-05-22
TL Number from the TL Form: C 849135
Sample Submitted By Organization: CT D03 - North Region Materials Lab
Sample Organization Contact: (530) 741-4238
Type of Sample: Verification
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 03/05/2021
Date that the sample was received by the laboratory/organization performing the testing: 03/08/2021
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: Rubber Binder PG-64-16
From where was the sample collected: Manufacturer
Laboratory sample identification: JMF21-009
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert Perkins - Continuous Plant Dreyer Drum

Material Information

Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:

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.