Sample Record

Owner Lab

  • Jaxon Enterprises - Deer Creek Rock & Asphalt

DIME Sample ID 2020-05-18-25

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 Date05/18/2020 Sample Unique Key25
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 testingNot set
Sample typeQuality Control A brief description of the sampleCombined Cold Feed
The quantity of what the sample constitutesCombined Cold Feed From where was the sample collectedSource
First name of sampler or witnessed byJordan Last name of sampler or witnessed byBaker
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameDeer Creek Rock and asphalt Transportation Laboratory (TL) Number
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAggregate Source Identification (SMARA or name of Pit)91-54-0021::DEER CREEK ASPHALT
The fabricator's/manufacturer's product name for the sample The fabricator/manufacturer designation for the sample
The plant number A detailed description of where the material sample was collectedCombined coldfeed
Where the material sample would have been placed if not sampled Primary Aggregate Nominal Size1/2 inch
The concrete mix design number Lot number
Sublot number HMA Design ID JMF3512-2020-292-20-0125.050O

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