Sample Record
Owner Lab
- CT D05 - Field Laboratory
DIME Sample ID 2020-09-17-21
Sample is locked from editing. info
Project Information
| Project Identifiers | Project ID: 214629 DEA: 051H9304 EFIS: 0517000017 |
|---|---|
| DIST-CO-RTE-PM | 05-SLO-46-R17.2/R17.6 |
| Award Date | 04/07/2020 |
| Closeout Date | Not set |
| Work Description | CONSTRUCT ROUNDABOUT. |
| Location Description | SAN LUIS OBISPO COUNTY NEAR TEMPLETON FROM 0.2 MILE WEST TO 0.2 MILE EAST OF VINEYARD DRIVE |
| QA Service Level | 1 (Verified on 02/20/2020) |
Sample Information
| Sample Taken Date | 09/17/2020 | Sample Unique Key | 21 |
|---|---|---|---|
| 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 | 09/25/2020 |
| Sample type | Verification | A brief description of the sample | Boxes of HMA-A |
| The quantity of what the sample constitutes | One JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Larry | Last name of sampler or witnessed by | Scott |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | CalPortland Paso Robles | 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 |
|---|---|---|---|
| HMA Grading | 3/4 inch | Lot number | |
| Sublot number | JMF Verification ID | JMF3513-2020-206 |