Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2019-05-29-25
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Project Information
| Project Identifiers | Project ID: 213791 DEA: 024H2204 EFIS: 0218000096 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS-89-28.0/34.0 |
| Award Date | 01/22/2019 |
| Closeout Date | 08/13/2021 |
| Work Description | PAVEMENT OVERLAY. |
| Location Description | SISKIYOU COUNTY NEAR MCCLOUD FROM 0.5 MILE SOUTH OF MOUNTAIN HOUSE ROAD TO 0.3 MILE SOUTH OF AZALEA ROAD |
| QA Service Level | 1 (Verified on 01/08/2019) |
Sample Information
| Sample Taken Date | 05/29/2019 | Sample Unique Key | 25 |
|---|---|---|---|
| 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 | 05/29/2019 |
| Sample type | Verification | A brief description of the sample | PG 58-22 (Valero – Benicia) |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Randy | Last name of sampler or witnessed by | Bibbens |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D77899 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Valero - Benicia | Transportation Laboratory (TL) Number | 991046 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
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 | JMF3513-2019-72 | Date Created | 07/05/2019 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2019-105 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | 19-1001.318-B | Authorized Date | 07/12/2019 |
Submitted Tests
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||
Test File Attachments
DIME Test ID: 2019-05-29-25-1 AASHTO T228-09r13 (Verified)