Sample Record
Owner Lab
- CT D03 - North Region Materials Lab
DIME Sample ID 2020-04-27-19
Sample is locked from editing. info
Project Information
Project Identifiers | Project ID: 214492 DEA: 033F5404 EFIS: 0313000136 |
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DIST-CO-RTE-PM | 03-SAC-99,160-4.5/5.7,R44.5 |
Award Date | 01/24/2020 |
Closeout Date | Not set |
Work Description | FURNISH PRECAST PRESTRESSED CONCRETE SLAB & PLACE STRUCTURAL CONCRETE. |
Location Description | SACRAMENTO COUNTY NEAR GALT ON ROUTE 99 FROM NORTH OF MINGO ROAD TO SOUTH OF ARNO ROAD OVERCROSSING AND IN SACRAMENTO ON ROUTE 160 AT AMERICAN RIVER BRIDGE |
QA Service Level | 1 (Verified on 10/23/2019) |
Sample Information
Sample Taken Date | 04/27/2020 | Sample Unique Key | 19 |
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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 | 04/28/2020 |
Sample type | Verification | A brief description of the sample | 3/4 inch HMA - A (SP) |
The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Walt | Last name of sampler or witnessed by | Wylie (Witness) |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | JMF20-009B | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Teichert Perkins | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Reclaimed Asphalt Pavement | RAP Source | Perkins 1111 |
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Aggregate Size | Aggregate Source | Perkins 1111 | |
RAP Stockpile | Continuous | Stockpile Size (tons) | |
JMF Verification ID | JMF3512-2020-313-PN203003-SP, JMF3513-2020-226 |