Sample Record
Owner Lab
- CT HQ - Hot Mix Asphalt Laboratory
DIME Sample ID 2019-04-12-12
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 66667 DEA: JMFPP EFIS: 0019000043 |
|---|---|
| DIST-CO-RTE-PM | 59--- |
| Award Date | Not set |
| Closeout Date | Not set |
| Work Description | Special project for submitting Sample information for JMF Prequalification Program. |
| Location Description | Not set |
| QA Service Level | NOT VERIFIED |
Sample Information
| Sample Taken Date | 04/12/2019 | Sample Unique Key | 12 |
|---|---|---|---|
| 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 | 04/22/2019 |
| Sample type | Verification | A brief description of the sample | 3/4 inch Type A HMA (eq. PG 70-10) |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Martiniano | Last name of sampler or witnessed by | Ruiz |
| Title of sampler | Mat and Res Eng Aso Spc | Telephone number of sampler | 5592894416 |
| Laboratory sample identification | 019-005 | Linked DIME Sample ID | NA |
| The fabricator/manufacturer/facility name | Deer Creek Porterville | Transportation Laboratory (TL) Number | HDQTRS Lab |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | Not set | |
| Structure name | Not set |
Material Information
| Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
|---|---|---|---|
| HMA Grading | 3/4 inch | Lot number | Unknown |
| Sublot number | Unknown | JMF Verification ID | JMF3513-2019-56 |