Sample Record

Owner Lab

  • Gallagher and Burk Materials

DIME Sample ID 2019-12-17-22

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 Date12/17/2019 Sample Unique Key22
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 testing12/18/2019
Sample typePreliminary A brief description of the sample1/2" Type "A" 15% RAP WM
The quantity of what the sample constitutes20000 tons From where was the sample collectedManufacturer
First name of sampler or witnessed byDon Last name of sampler or witnessed byEvans
Title of samplerquality technician Telephone number of sampler5109151236
Laboratory sample identificationMD 6757 WM Linked DIME Sample ID
The fabricator/manufacturer/facility nameGallagher and Burk Materials Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading1/2 inch Lot number1
Sublot number1 HMA Mix NumberNot set

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