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Sample Record for 2021-04-28-32

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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: 2021-04-28-32
TL Number from the TL Form: C741863
Sample Submitted By Organization: CT D03 - North Region Materials Lab
Sample Organization Contact: (530) 741-4238
Type of Sample: Verification
Type of Material: Asphalt Modifier
Sample Taken Date: 04/28/2021
Date that the sample was received by the laboratory/organization performing the testing: 04/28/2021
The quantity of what the sample constitutes: Asphalt Modifier 2% by weight of Asphalt Binder
A brief description of the sample: Asphalt Modifier - Hydrolyne H110T
From where was the sample collected: Manufacturer
Laboratory sample identification: JMF21-024
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Teichert-Hallwood Plant

Material Information

Asphalt Modifier Type: Hydrolyne H110T

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.