Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2019-01-29-15
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Project Information
| Project Identifiers | Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125 |
|---|---|
| DIST-CO-RTE-PM | 02-SHA-5-R3.8/R11.7 |
| Award Date | 11/06/2018 |
| Closeout Date | 08/16/2023 |
| Work Description | WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB |
| Location Description | SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING |
| QA Service Level | 1 (Verified on 12/31/2018) |
Sample Information
| Sample Taken Date | 01/29/2019 | Sample Unique Key | 15 |
|---|---|---|---|
| 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 | 02/01/2019 |
| Sample type | Verification | A brief description of the sample | PG 58-22 |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Anthony | Last name of sampler or witnessed by | Ortiz |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D77790 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Valero-Benicia Asphalt Plant | Transportation Laboratory (TL) Number | 736645 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 58-22 |
|---|---|---|---|
| Modified | No | Lot number | Not set |
| Sublot number | Not set | Tank number | Not set |
| Time of sample | Not set | HMA Supplier | Not set |
| Certified Asphalt Supplier | Not set | Multigrade | Not set |
| Multigrade Type | Not set | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2019-49 | Date Created | 02/08/2019 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2019-66 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 19-1001.314 | Authorized Date | 02/26/2019 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-01-29-15-1 AASHTO T228-09r13 (Verified)