Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 66667 DEA: JMFPP EFIS: 0019000043
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for JMF Prequalification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
DIME Sample ID: 2021-06-03-38
TL Number from the TL Form:
Sample Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Sample Organization Contact: 213-792-4794
Type of Sample: Verification
Type of Material: Asphalt Rubber Binder
Sample Taken Date: 06/03/2021
Date that the sample was received by the laboratory/organization performing the testing: 08/02/2021
The quantity of what the sample constitutes: 1 Quart Can
A brief description of the sample: Asphalt Rubber Binder
From where was the sample collected: Supplier
Laboratory sample identification: 0438-21
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: All American Asphalt-Irwindale
Asphalt modifier supplier:
Performance Grade: PG 64-16
Lot number:
Sublot number:
Asphalt Rubber Binder Mix Number:
DIME Test ID: 2021-06-03-38-1
Test Method: ASTM D217-16: Standard Test Methods for Cone Penetration of Lubricating Grease (Cone Penetration)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2021-06-03-38-2
Test Method: ASTM D36-14ε1: Standard Test Method for Softening Point of Bitumen (Ring-and-Ball Apparatus) (Softening Point)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.
DIME Test ID: 2021-06-03-38-3
Test Method: ASTM D5329-16: Standard Test Methods for Sealants and Fillers, Hot-Applied, for Joints and Cracks in Asphalt Pavements and Portland Cement Concrete Pavements (Asphalt Pavement)
Submitted By Organization: CT D08 - Fontana Southern Regional Laboratory
Organization Address: 13970 Victoria Street,
Organization City: Fontana
Organization State: CA
Organization Zipcode: 92336
Organization Email: jose.guzman@dot.ca.gov
Organization Phone: 9098293029
Data has not been verified.