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Sample Record for 2021-04-01-27

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

Project Information

Project ID: 212914 DEA: 031E0604 EFIS: 0312000068 QA Service Level: 1
DIST-CO-RTE-PM: 03-YUB-70-15.5/16.5
Work Description: SIMMERLY SLOUGH BRIDGE REPLACEMENT BR 16-0019 WITH BR 16-0055.
Location Description: NEAR MARYSVILLE, FROM 0.1 MILE NORTH OF BINNEY JUNCTION UNDERPASS TO 0.3 MILE NORTH OF LAURELLEN ROAD, AT SIMMERLY SLOUGH BRIDGE BR 16-0019.
Contractor Name: MCM Construction
Contractor Address: PO Box 620, North Highlands, Ca 95660
Resident Engineer: Manoharan Selvendran Structure Rep.: Travis Christie

Sample Information

DIME Sample ID: 2021-04-01-27
TL Number from the TL Form: C706328
Sample Submitted By Organization: CT D03 - North Region Materials Lab
Sample Organization Contact: (530) 741-4238
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 04/01/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/01/2021
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: PG 64-16 Asphalt Binder
From where was the sample collected: Manufacturer
Laboratory sample identification: JMF21-020A
Structure unique identifier:
Structure name: Not Applicable
The fabricator/manufacturer/facility name: Teichert-Hallwood Drum Plant

Material Information

Performance Grade: PG 64-16
Modified: No
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier: Teichert - Hallwood Drum Plant
Asphalt Binder Supplier: Pacific Northwest Oil - Stockton CA
Multigrade: No
Multigrade Type:

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.