Sample Record

Owner Lab

  • CT D05 - San Luis Obispo District Laboratory

DIME Sample ID 2020-01-30-19

Project Information

Project IdentifiersProject ID: 214634
DEA: 051M2404
EFIS: 0519000085
DIST-CO-RTE-PM05-SB-101-21.8/22.0
Award DateNot set
Closeout DateNot set
Work DescriptionGoleta Cross Slope Correction
Location DescriptionNot set
QA Service Level1 (Verified on 02/20/2020)

Sample Information

Sample Taken Date01/30/2020 Sample Unique Key19
Will the laboratory/organization for which you are a member perform testing on this material sample?No Date that the sample was received by the laboratory/organization performing the testing01/31/2020
Sample typeVerification A brief description of the sample1 Quart can
The quantity of what the sample constitutesVerification Testing From where was the sample collectedOther
First name of sampler or witnessed bySal Last name of sampler or witnessed byZamora
Title of sampler Telephone number of sampler
Laboratory sample identificationD5 20-J-001 Linked DIME Sample ID
The fabricator/manufacturer/facility nameWorld Oil Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance Grade64-10
ModifiedNo Lot numberNot set
Sublot numberNot set Tank numberNot set
Time of sampleNot set HMA SupplierNot set
Certified Asphalt SupplierNot set MultigradeNot set
Multigrade TypeNot set Asphalt Binder Mix NumberNot set

JMF Information

Verification IDJMF3513-2020-93 Date Created01/31/2020
JMF Submittal IDJMF3511-173-2020-136 JMF StatusSubmittal Authorized For Use
Producer Mix IDD1321F515 Authorized Date02/20/2020

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments