Sample Record
Owner Lab
- CT D02 - Redding Northern Regional Laboratory
DIME Sample ID 2021-02-16-36
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 214515 DEA: 024F6004 EFIS: 0213000012 |
|---|---|
| DIST-CO-RTE-PM | 02-SIS,TRI-36,96,299-VAR |
| Award Date | 01/14/2020 |
| Closeout Date | 08/24/2022 |
| Work Description | BRIDGE DECK REPAIR, POLYESTER OVERLAY AND RAIL REPLACEMENT. |
| Location Description | SISKIYOU AND TRINITY COUNTIES AT VARIOUS LOCATIONS |
| QA Service Level | 1 (Verified on 01/22/2020) |
Sample Information
| Sample Taken Date | 02/16/2021 | Sample Unique Key | 36 |
|---|---|---|---|
| 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 | 02/16/2021 |
| Sample type | Verification | A brief description of the sample | PG 64-28 M |
| The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Cindy | Last name of sampler or witnessed by | Bryant |
| Title of sampler | Telephone number of sampler | ||
| Laboratory sample identification | D78746 | Linked DIME Sample ID | |
| The fabricator/manufacturer/facility name | Valero - Benicia, CA | Transportation Laboratory (TL) Number | 815632 |
| 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 |
|---|---|---|---|
| Modified | Yes | Lot number | |
| Sublot number | Tank number | ||
| Time of sample | HMA Supplier | Mercer-Fraser Company – Willow Creek Plant (Willow Creek, CA) | |
| 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 | JMF3513-2021-40 | Date Created | 04/02/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-22-2021-52 | JMF Status | Submittal Accepted for Verification |
| Producer Mix ID | L202327 | Authorized Date | N/A |
Submitted Tests
| DIME Test ID | Test Method | Tester Name, Testing Lab | Date Tested | Submitted By | Verified? | Release Date | Test Comments | Actions |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||