Sample Record
Owner Lab
- CT D02 - North Region Materials Lab
DIME Sample ID 2019-05-23-18
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 211775 DEA: 024E6504 EFIS: 0212000012 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-96-R52.5/88.4 |
| Award Date | 07/10/2017 |
| Closeout Date | 01/05/2021 |
| Work Description | WIDEN BRIDGES,POLYESTER CONC OVERLAY,COLD PLANE AC PVMT,HMA,GUARDRAIL |
| Location Description | SISKIYOU COUNTY NEAR SEIAD VALLEY AT VARIOUS LOCATIONS FROM 0.1 MILE WEST OF THOMPSON CREEK BRIDGE TO 0.2 MILE EAST OF BEAVER CREEK BRIDGE |
| QA Service Level | 1 (Verified on 08/23/2017) |
Sample Information
| Sample Taken Date | 05/23/2019 | Sample Unique Key | 18 |
|---|---|---|---|
| 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 | 05/23/2019 |
| Sample type | Verification | A brief description of the sample | 3/8-inch Minus RAP (3/8-inch) |
| The quantity of what the sample constitutes | JMF Modification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Derrick | Last name of sampler or witnessed by | Curry |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D77889B | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Fawndale Rock and Asphalt | Transportation Laboratory (TL) Number | 001377 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Reclaimed Asphalt Pavement | RAP Source | Fawndale |
|---|---|---|---|
| Aggregate Size | Combined 3/8-inch | Aggregate Source | Unknown |
| RAP Stockpile | Stockpile Size (tons) | Unknown | |
| JMF Verification ID | JMF3513-2019-71 |