Sample Record

Owner Lab

  • Gallagher and Burk Materials

DIME Sample ID 2021-01-07-1

Project Information

Project IdentifiersProject ID: 66667
EFIS: 0019000043
Award DateNot set
Closeout DateNot set
Work DescriptionSpecial project for submitting Sample information for JMF Prequalification Program.
Location DescriptionNot set

Sample Information

Sample Taken Date01/07/2021 Sample Unique Key1
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 testing12/02/2020
Sample typePer Request A brief description of the sample3/4" HMA-A 25% RAP Verification Sample
The quantity of what the sample constitutesAnnual From where was the sample collectedSupplier
First name of sampler or witnessed byLisa Last name of sampler or witnessed byNordine
Title of samplerLab Supervisor Telephone number of sampler925 719-3671
Laboratory sample identificationMD 6741 Linked DIME Sample ID66667
The fabricator/manufacturer/facility nameGallagher and Burk Materials Transportation Laboratory (TL) Number265
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeHot Mix Asphalt HMA TypeType A HMA
HMA Grading3/4 inch Lot number
Sublot number HMA Mix NumberNot set

Submitted Tests

DIME Test IDTest MethodTester Name, Testing LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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Sample File Attachments

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Test File Attachments