Sample Record

Owner Lab

  • CT HQ - Sacramento Hot Mix Asphalt Laboratory

DIME Sample ID 2020-03-27-11

Project Information

Project IdentifiersProject ID: 66667
DEA: JMFPP
EFIS: 0019000043
DIST-CO-RTE-PM59---
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for JMF Prequalification Program.
Location DescriptionNot set
QA Service LevelNOT VERIFIED

Sample Information

Sample Taken Date03/27/2020 Sample Unique Key11
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 testing03/27/2020
Sample typeVerification A brief description of the samplePG 64-16
The quantity of what the sample constitutes2 cans From where was the sample collectedOther
First name of sampler or witnessed byEd Last name of sampler or witnessed byGamboa
Title of samplerMREA Telephone number of sampler2094977814
Laboratory sample identificationJMF-020-009 Linked DIME Sample ID
The fabricator/manufacturer/facility nameValero Oil Transportation Laboratory (TL) NumberNA
Inspector Lot Number from the Transportation Laboratory (TL) FormNA Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
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 IDJMF3513-2020-103 Date Created04/03/2020
JMF Submittal IDJMF3511-208-2020-147 JMF StatusSubmittal Accepted for Verification
Producer Mix ID311101510-LB_0320 Authorized DateN/A

Submitted Tests

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

File NameExtensionDate UploadedActions
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Test File Attachments