Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2017-11-01-36

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 9999
DEA: 00000000
EFIS: 0000000000
COOP: 99999333399
MINOR: 333333
Permit Numbers: 555555 0400NRT0000
DIST-CO-RTE-PM03-SAC,OMG-888,99,80-0.6-0.6
Award DateNot set
Closeout DateNot set
Work DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location DescriptionTHIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
QA Service Level1 (Verified on 04/05/2013)

Sample Information

Sample Taken Date11/01/2017 Sample Unique Key36
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 testing11/01/2017
Sample typeVerification A brief description of the sampleJMF Verification
The quantity of what the sample constitutes1 From where was the sample collectedManufacturer
First name of sampler or witnessed byThinh Last name of sampler or witnessed byNguyen
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility namePacific Northwest Oil - Stockton, CA Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeCrumb Rubber Modifier CRM TypeScrap Tire
Crumb Rubber Modifier Mix NumberNot set HMA PayNo

JMF Information

Verification IDJMF3513-2017-1 Date Created11/01/2017
JMF Submittal IDJMF3511-6-2017-1 JMF StatusSubmittal Authorized For Use
Producer Mix ID5202 Authorized Date03/15/2018

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2017-11-01-36-1ASTM D297-15: Standard Test Methods for Rubber Products - Chemical Analysis (Chemical Analysis)David Phong, CT HQ - Sacramento Materials Management Branch Field Office02/08/2018David Phong
Yes
02/08/2018
2017-11-01-36-2CTM 208-September 2011: Method of Test for Apparent Specific Gravity of Fine AggregatesDavid Phong, CT HQ - Sacramento Materials Management Branch Field Office02/01/2018David Phong
Yes
02/08/2018
2017-11-01-36-3CTM 385-November 2016: Method of Test for Sampling and Testing Crumb Rubber Modifier (CRM)David Phong, CT HQ - Sacramento Materials Management Branch Field Office02/08/2018David Phong
Yes
02/08/2018

Sample File Attachments

File NameExtensionDate UploadedActions
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Test File Attachments


DIME Test ID: 2017-11-01-36-1 ASTM D297-15 (Verified)
DIME Test ID: 2017-11-01-36-2 CTM 208-September 2011 (Verified)
DIME Test ID: 2017-11-01-36-3 CTM 385-November 2016 (Verified)