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Sample Record for 2022-03-17-76

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

Project Information

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

Sample Information

DIME Sample ID: 2022-03-17-76
TL Number from the TL Form:
Sample Submitted By Organization: CT D02 - Redding Northern Regional Laboratory
Sample Organization Contact: (530) 225-3194
Type of Sample: Verification
Type of Material: Asphalt Binder
Sample Taken Date: 03/17/2022
Date that the sample was received by the laboratory/organization performing the testing: 03/21/2022
The quantity of what the sample constitutes: JMF Verification
A brief description of the sample: 2 cans of PG 58-34 M binder
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Valero - Benicia, CA

Material Information

Performance Grade: PG 58-34 M
Modified:
Lot number: 0
Sublot number: 0
Tank number:
Time of sample: 2022-03-21
HMA Supplier: Tullis - Northstate Asphalt - Redding, CA
Certified Asphalt Supplier: Valero Marketing & Supply - Benicia CA
Multigrade: No
Multigrade Type:
Asphalt Binder Mix Number:

Test Results