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Sample Record for 2021-06-16-13

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

Project Information

Project ID: 215092 DEA: 101C0404 EFIS: 1017000034 QA Service Level: 1
DIST-CO-RTE-PM: 10-MPA-49-0.3/18.5
Work Description: COLD PLANE, PLACE HMA AND REPLACE RAILING AND OVERSIDE DRAINS.
Location Description: MARIPOSA COUNTY IN AND NEAR MARIPOSA FROM MADERA COUNTY LINE TO SOUTH JUNCTION ROUTE 140
Contractor Name: A. TEICHERT & SON INC. DBA TEICHERT CONSTRUCTION
Contractor Address: 400 Sunrise Ave Ste 300,, Roseville, CA 95661
Resident Engineer: Stan Oshita Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-06-16-13
TL Number from the TL Form: 031000
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 06/16/2021
Date that the sample was received by the laboratory/organization performing the testing: 06/21/2021
The quantity of what the sample constitutes: 1 of 2 cans
A brief description of the sample: NOT TESTED Rubberized Binder
From where was the sample collected: Source
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: MARATHON ELK GROVE

Material Information

Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number: 1
Sublot number: 1

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.