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Sample Record for 2021-09-08-19

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

Project Information

Project ID: 215393 DEA: 021J5104 EFIS: 0220000086 QA Service Level: 1
DIST-CO-RTE-PM: 02-LAS,MOD-139-57.0/66.635,0.0/0.1
Work Description: PERFORM COLD IN-PLACE RECYCLING AND PLACE HOT MIX ASPHALT (TYPE A).
Location Description: LASSEN AND MODOC COUNTIES NEAR ADIN FROM 4.5 MILES SOUTH OF COUNTY ROAD A2 TO 0.1 MILE SOUTH OF ROUTE 299
Contractor Name: Hat Creek Construction
Contractor Address: 24339 Highway 89 N, Burney, CA 96013
Resident Engineer: Mike Zdenek Structure Rep.: Unknown

Sample Information

DIME Sample ID: 2021-09-08-19
TL Number from the TL Form: c858995
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Acceptance
Type of Material: Asphaltic Emulsion
Sample Taken Date: 09/08/2021
Date that the sample was received by the laboratory/organization performing the testing: 09/08/2021
The quantity of what the sample constitutes: 1 jug
A brief description of the sample: Tack
From where was the sample collected: Job Site
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Albina

Material Information

Emulsion Grade: CQS-1
Lot Number:
Sub Lot:

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.