Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2019-06-11-21

Sample is locked from editing. info

Project Information

Project IdentifiersProject ID: 212562
DEA: 024G5504
EFIS: 0214000036
DIST-CO-RTE-PM02-SIS-5-2.7/R11.4
Award Date03/12/2018
Closeout Date10/05/2020
Work DescriptionRECONSTRUCT WITH HMA AND PCC, WIDEN STRUCTURE AND UPGRADE RAILS
Location DescriptionSISKIYOU COUNTY IN AND NEAR DUNSMUIR FROM SACRAMENTO RIVER BRIDGE TO 0.6 MILE SOUTH OF NORTH MOUNT SHASTA UNDERPASS
QA Service Level1 (Verified on 04/04/2018)

Sample Information

Sample Taken Date06/11/2019 Sample Unique Key21
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 testing06/12/2019
Sample typeVerification A brief description of the samplePG 58-34 M (Albina – Klamath Falls)
The quantity of what the sample constitutesJMF Renewal From where was the sample collectedManufacturer
First name of sampler or witnessed byJohn Last name of sampler or witnessed byCarmichael
Title of sampler Telephone number of sampler
Laboratory sample identificationD77929 Linked DIME Sample ID
The fabricator/manufacturer/facility nameAlbina - Klamath Falls, OR Transportation Laboratory (TL) Number991054
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 58-34 M
ModifiedYes Lot numberNot set
Sublot numberNot set Tank numberNot set
Time of sampleNot set HMA SupplierNot set
Asphalt Binder SupplierNot set MultigradeNot set
Multigrade TypeNot set JMF Verification ID JMF3513-2019-75

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
2019-06-11-21-1AASHTO T228-09r13: Standard Method of Test for Specific Gravity of Semi-Solid Asphalt Materials (Specific Gravity)CEM-3512CT D02 - North Region Materials Lab06/12/2019Ward Jenkins
Yes
07/26/2019