Sample Record
Owner Lab
- CT D03 - Olivehurst Northern Regional Laboratory
DIME Sample ID 2021-03-05-25
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 | 07/28/2022 |
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 | 03/05/2021 | Sample Unique Key | 25 |
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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 | 03/08/2021 |
Sample type | Verification | A brief description of the sample | Asphalt Modifier (PG-64-16) |
The quantity of what the sample constitutes | JMF Verification | From where was the sample collected | Manufacturer |
First name of sampler or witnessed by | Sam Mossallem (Witness) | Last name of sampler or witnessed by | Teichert Personnel (SAMPLER) |
Title of sampler | Teichert Personnel | Telephone number of sampler | Unknown |
Laboratory sample identification | JMF21-009 | Linked DIME Sample ID | |
The fabricator/manufacturer/facility name | Teichert Perkins - Continuous Plant Dreyer Drum | Transportation Laboratory (TL) Number | C 849135 |
Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
Structure name |
Material Information
Material Type | Asphalt Modifier | Asphalt Modifier Type | Tricor Refining |
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Asphalt Modifier Mix Number | Not set |
JMF Information
Verification ID | JMF3513-2021-45 | Date Created | 04/15/2021 |
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JMF Submittal ID | JMF3511-23-2021-57 | JMF Status | Submittal Authorized For Use |
Producer Mix ID | GC202102-SP | 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. |