Sample Record

Owner Lab

  • CT D02 - North Region Materials Lab

DIME Sample ID 2020-10-08-36

Project Information

Project IdentifiersProject ID: 214190
DEA: 024G41U4
EFIS: 0218000047
DIST-CO-RTE-PM02-SIS,SIS-5-Var
Award Date08/26/2019
Closeout Date11/24/2021
Work DescriptionREPLACE REINFORCED CONCRETE BRIDGES & CONSTRUCT RETAINING WALL.
Location DescriptionSHASTA AND SISKIYOU COUNTIES ABOUT 7 MILES NORTH OF POLLARD FLAT FROM 0.8 MILE SOUTH TO 0.7 MILE NORTH OF SIMS ROAD UNDERCROSSING AND FROM 0.6 MILE SOUTH OF CASTLE CRAGS DRIVE UNDERCROSSING TO 0.2 MILE SOUTH OF SOUTH DUNSMUIR UNDERCROSSING
QA Service Level1 (Verified on 07/09/2019)

Sample Information

Sample Taken Date10/08/2020 Sample Unique Key36
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 testing10/15/2020
Sample typeAcceptance A brief description of the samplePG 58-34M #2 No test
The quantity of what the sample constitutes1 Can From where was the sample collectedSource
First name of sampler or witnessed byJF Last name of sampler or witnessed byshea
Title of sampler Telephone number of sampler
Laboratory sample identification Linked DIME Sample ID
The fabricator/manufacturer/facility nameValero Benicia Transportation Laboratory (TL) Number779353
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 58-34 M
ModifiedYes Lot number
Sublot number Tank number
Time of sample HMA Supplier
Asphalt Binder SupplierValero Marketing & Supply - Benicia CA MultigradeNo
Multigrade Type HMA Design ID JMF3513-2021-84

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
No results found.