Sample Record
Owner Lab
- CT - Southern Regional Laboratory
DIME Sample ID 2019-11-18-1
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 213746 DEA: 080Q75U4 EFIS: 0817000114 |
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DIST-CO-RTE-PM | 08-SBD,RIV-60-R4.6/R9.9, R0.0/12.2 |
Award Date | Not set |
Closeout Date | Not set |
Work Description | REPLACEMENT OF TWO OUTSIDE LANES AND CONCRETE SLABS |
Location Description | Not set |
QA Service Level | 1 (Verified on 06/17/2019) |
Sample Information
Sample Taken Date | 11/18/2019 | Sample Unique Key | 1 |
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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 | 11/19/2019 |
Sample type | Acceptance | A brief description of the sample | 1/2" HMA-A PG 64-28M 0.25% LAS |
The quantity of what the sample constitutes | 2 boxes | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | QC | Last name of sampler or witnessed by | QC |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | 0693A-19 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Vulcan-Corona | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Hot Mix Asphalt | HMA Type | Type A HMA |
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HMA Grading | 1/2 inch | Lot number | Unknown |
Sublot number | Unknown | HMA Design ID |