Sample Record
Owner Lab
- CT D02 - North Region Materials Lab
DIME Sample ID 2020-10-20-7
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 213469 DEA: 024C40V4 EFIS: 0218000125 |
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DIST-CO-RTE-PM | 02-SHA-5-R3.8/R11.7 |
Award Date | 11/06/2018 |
Closeout Date | Not set |
Work Description | WIDEN TO 6 LANES, BRIDGE REPLACEMENT AND WIDENING AND ROADWAY REHAB |
Location Description | SHASTA COUNTY IN AND NEAR ANDERSON FROM ROUTE 5/273 SEPARATION TO 0.4 MILE SOUTH OF CHURN CREEK ROAD OVERCROSSING |
QA Service Level | 1 (Verified on 12/31/2018) |
Sample Information
Sample Taken Date | 10/20/2020 | Sample Unique Key | 7 |
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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 | 10/23/2020 |
Sample type | Verification | A brief description of the sample | Asphalt Rubber Binder |
The quantity of what the sample constitutes | ARB Rcvd 2 cans #21 Test | From where was the sample collected | Source |
First name of sampler or witnessed by | C | Last name of sampler or witnessed by | Bryant |
Title of sampler | TET | Telephone number of sampler | |
Laboratory sample identification | Linked DIME Sample ID | ||
The fabricator/manufacturer/facility name | Valero | Transportation Laboratory (TL) Number | 853473 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Asphalt Rubber Binder | Asphalt modifier supplier | |
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Performance Grade | PG 64-16 | Lot number | |
Sublot number | JMF Verification ID | JMF3513-2021-83 |