Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2020-10-25-10
Project Information
Project Identifiers | Project ID: 213411 DEA: 030H10U4 EFIS: 0317000246 |
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DIST-CO-RTE-PM | 03-SAC-5-9.7/24.9 |
Award Date | 05/01/2019 |
Closeout Date | 02/22/2024 |
Work Description | Not set |
Location Description | Construction on state highway in Sacramento County in and near Sacramento from 1.1 miles south of Elk Grove Boulevard to American River Viaduct |
QA Service Level | 1 (Verified on 07/19/2019) |
Sample Information
Sample Taken Date | 10/25/2020 | Sample Unique Key | 10 |
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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 testing | 01/07/2021 |
Sample type | Verification | A brief description of the sample | PG 64-28m Valero |
The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | J. Buscheck (WITNESS) | Last name of sampler or witnessed by | Teichert Personnel (SAMPLER) |
Title of sampler | Telephone number of sampler | ||
Laboratory sample identification | JMF21-002 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Teichert Perkins Batch Plant | Transportation Laboratory (TL) Number | |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Asphalt Binder | Performance Grade | PG 64-28 M |
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Modified | Yes | Lot number | |
Sublot number | Tank number | ||
Time of sample | HMA Supplier | ||
Certified Asphalt Supplier | Valero Marketing & Supply - Benicia CA | Multigrade | Not set |
Multigrade Type | Not set | Asphalt Binder Mix Number | Not set |
JMF Information
Verification ID | JMF3513-2021-34 | Date Created | 03/19/2021 |
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JMF Submittal ID | JMF3511-23-2021-46 | JMF Status | Submittal Authorized For Use |
Producer Mix ID | PN202002-SRF | Authorized Date | 09/10/2021 |
Submitted Tests
DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
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No results found. |
Sample File Attachments
File Name | Extension | Date Uploaded | Actions |
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No results found. |