Sample Record for 2021-10-25-14
Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project Information
Project ID: 44444 DEA: ASCP EFIS: ASCP
QA Service Level:
DIST-CO-RTE-PM: 59---
Work Description: Special project for submitting Sample information for Asphalt Supplier Certification Program.
Location Description:
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: Unknown Structure Rep.: Unknown
Sample Information
DIME Sample ID: 2021-10-25-14
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Sample Organization Contact: (916) 227-7302
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 10/25/2021
Date that the sample was received by the laboratory/organization performing the testing: 10/25/2021
The quantity of what the sample constitutes: 1 of 1
A brief description of the sample: Tank 38
From where was the sample collected: Manufacturer
Laboratory sample identification: PG5834M102521KF38
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Klamath Falls, OR
Material Information
Performance Grade: PG 58-34M
Modified:
Lot number:
Sublot number:
Tank number:
Time of sample:
HMA Supplier:
Certified Asphalt Supplier: Albina Asphalt
Multigrade:
Multigrade Type:
Asphalt Binder Mix Number:
Test Results
Test 1 of 3
DIME Test ID: 2021-10-25-14-1
Test Method: AASHTO T316-17: Standard Method of Test for Viscosity Determination of Asphalt Binder Using Rotational Viscometer
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.
Test 2 of 3
DIME Test ID: 2021-10-25-14-2
Test Method: AASHTO T48-18: Standard Method of Test for Flash Point of Asphalt Binder by Cleveland Open Cup
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard, Room 225,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.
Test 3 of 3
DIME Test ID: 2021-10-25-14-3
Test Method: AASHTO T301-13: Standard Method of Test for Elastic Recovery Test of Asphalt Materials by Means of a Ductilometer
Submitted By Organization: CT HQ - Sacramento Asphalt Binder Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: guadalupe.magana@dot.ca.gov
Organization Phone: (916) 227-7302
Data has not been verified.
