Sample Record

Owner Lab

  • CT D05 - San Luis Obispo District Laboratory

DIME Sample ID 2020-06-29-22

Project Information

Project IdentifiersProject ID: 214731
DEA: 051M0004
EFIS: 0519000047
DIST-CO-RTE-PM05-SLO-101-16.5/R21.5
Award Date04/22/2020
Closeout Date08/23/2021
Work DescriptionCOLD PLANE AND RHMA-GAP GRADED OVERLAY ON EXISTING ROADWAY.
Location DescriptionSAN LUIS OBISPO COUNTY IN AND NEAR PISMO BEACH FROM 0.1 MILE SOUTH OF PRICE CANYON ROAD TO SAN LUIS CREEK BRIDGE
QA Service Level1 (Verified on 05/29/2020)

Sample Information

Sample Taken Date06/29/2020 Sample Unique Key22
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 testing06/29/2020
Sample typeVerification A brief description of the sampleQuart can of ARB
The quantity of what the sample constitutesOne JMF Verification From where was the sample collectedManufacturer
First name of sampler or witnessed bySal Last name of sampler or witnessed byLopez
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameFNF Avenal Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Rubber Binder Asphalt modifier supplier
Performance GradeNot set Lot numberNot set
Sublot numberNot set Asphalt Rubber Binder Mix NumberNot set

JMF Information

Verification IDJMF3513-2020-150 Date Created07/02/2020
JMF Submittal IDJMF3511-173-2020-225 JMF StatusSubmittal Rejected For Use
Producer Mix IDTEM12RGLM Rejected Date07/02/2020

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments