Sample Record

Owner Lab

  • CT D09 - Bishop Field Laboratory

DIME Sample ID 2018-06-28-3

Project Information

Project IdentifiersProject ID: 212408
DEA: 09350804
EFIS: 0900020055
DIST-CO-RTE-PM09-MNO-395-80.6/84.1
Award Date07/14/2017
Closeout Date01/06/2020
Work DescriptionCONSTRUCT PULVERIZED ROADBED, HMA AND ANCHORED WIRE MESH SYSTEM.
Location DescriptionMONO COUNTY NEAR BRIDGEPORT FROM BUCKEYE ROAD TO 2.9 MILES SOUTH OF SWAUGER CANYON ROAD
QA Service Level1 (Verified on 05/03/2018)

Sample Information

Sample Taken Date06/28/2018 Sample Unique Key3
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 testing06/29/2018
Sample typeQuality Assurance A brief description of the sample3/4 HMA A 15 RAP PG58-34m
The quantity of what the sample constitutes750 Tons From where was the sample collectedJob Site
First name of sampler or witnessed byMokhtar Last name of sampler or witnessed byOuhamane
Title of samplerMaterials Tester Telephone number of sampler7609378955
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameRoad and Highway Builders Transportation Laboratory (TL) NumberUnknown
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot numberNot set
Sublot numberNot set HMA Mix NumberNot set
HMA PayNo

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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