Sample Record
Owner Lab
- CT HQ - Sacramento Asphalt Binder Laboratory
DIME Sample ID 2021-06-22-44
Project Information
Project Identifiers | Project ID: 215441 DEA: 021J5204 EFIS: 0220000087 |
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DIST-CO-RTE-PM | 02-MOD,SIS-139-34.0/50.7,0.0/5.0 |
Award Date | 03/02/2021 |
Closeout Date | 09/27/2021 |
Work Description | PLACE ASPHALT RUBBER BINDER CHIP SEAL & REPLACE AC SURFACING. |
Location Description | MODOC AND SISKIYOU COUNTIES AT AND NEAR NEWELL FROM 3.3 MILES NORTH OF PEREZ OVERHEAD TO ROUTE 161 |
QA Service Level | 1 (Verified on 02/01/2021) |
Sample Information
Sample Taken Date | 06/22/2021 | Sample Unique Key | 44 |
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Will the laboratory/organization for which you are a member perform testing on this material sample? | Yes | Date that the sample was received by the laboratory/organization performing the testing | 07/13/2021 |
Sample type | Acceptance | A brief description of the sample | Rubberized PG58-22 |
The quantity of what the sample constitutes | 1 of 2 gallon can | From where was the sample collected | Distributor |
First name of sampler or witnessed by | Jacob | Last name of sampler or witnessed by | S |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Albina - Klamath Falls | Transportation Laboratory (TL) Number | 815585 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Asphalt Rubber Binder | Asphalt modifier supplier | |
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Performance Grade | PG 58-22 | Lot number | |
Sublot number | Asphalt Rubber Binder Mix Number | Not set |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |