Sample Record

Owner Lab

  • CT D03 - North Region Materials Lab

DIME Sample ID 2021-03-12-15

Project Information

Project IdentifiersProject ID: 214900
DEA: 034F8104
EFIS: 0314000291
DIST-CO-RTE-PM03-GLE-32-L0.0/R0.3,0.1/0.9
Award Date06/15/2020
Closeout Date06/29/2021
Work DescriptionCONSTRUCT SIDEWALKS, CURB RAMPS, & DRIVEWAYS.
Location DescriptionGLENN COUNTY IN ORLAND AT VARIOUS LOCATIONS FROM ROUTE 5 SOUTHBOUND OFF RAMP TO ROUTE 32 TO NINTH STREET/TEHAMA STREET AND FROM FOURTH STREET TO WOODWARD AVENUE
QA Service Level1 (Verified on 04/15/2020)

Sample Information

Sample Taken Date03/12/2021 Sample Unique Key15
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 testing03/12/2021
Sample typeVerification A brief description of the samplePG 64-16
The quantity of what the sample constitutesJMF Verification From where was the sample collectedManufacturer
First name of sampler or witnessed byBrad McKeehan (WITNESS) Last name of sampler or witnessed byKRC Personnel (SAMPLER)
Title of sampler Telephone number of sampler
Laboratory sample identificationJMF21-003 Linked DIME Sample ID
The fabricator/manufacturer/facility nameKnife River Construction - Orland Drum Plant Transportation Laboratory (TL) NumberC778174
Inspector Lot Number from the Transportation Laboratory (TL) Form Structure unique identifier
Structure name

Material Information

Material TypeAsphalt Binder Performance GradePG 64-16
ModifiedNo Lot number
Sublot number Tank number
Time of sample HMA Supplier
Asphalt Binder SupplierValero Marketing & Supply - Benicia CA MultigradeNot set
Multigrade TypeNot set JMF Verification ID JMF3513-2021-38

Submitted Tests

DIME Test IDTest MethodTester NameTesting LabDate TestedSubmitted ByVerified?Release DateTest CommentsActions
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