Sample Record

Owner Lab

  • CT HQ - Sacramento Materials Management Branch Field Office

DIME Sample ID 2018-09-17-5

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 Date09/17/2018 Sample Unique Key5
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 testing09/17/2018
Sample typeQuality Control A brief description of the sampledime test
The quantity of what the sample constitutesTEST From where was the sample collectedSource
First name of sampler or witnessed bytest Last name of sampler or witnessed bytest
Title of samplerUnknown Telephone number of samplerUnknown
Laboratory sample identificationUnknown Linked DIME Sample IDUnknown
The fabricator/manufacturer/facility nameTest Transportation Laboratory (TL) Number101
Inspector Lot Number from the Transportation Laboratory (TL) FormUnknown Structure unique identifierNot set
Structure nameNot set

Material Information

Material TypeAsphalt Binder Performance Grade65
ModifiedNot set Lot numberNot set
Sublot numberNot set Tank numberNot set
Time of sampleNot set HMA SupplierNot set
Certified Asphalt SupplierNot set MultigradeNot set
Multigrade TypeNot set Asphalt Binder Mix NumberNot set
HMA PayNo

Submitted Tests

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

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Test File Attachments