Sample Record
Owner Lab
- CT HQ - Sacramento Asphalt Binder Laboratory
DIME Sample ID 2021-04-22-19
Sample Details QR Code
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Project Information
| Project Identifiers | Project ID: 215307 DEA: 033F5004 EFIS: 0313000019 |
|---|---|
| DIST-CO-RTE-PM | 03-GLE-5-R7.4/R17.0 |
| Award Date | 01/04/2021 |
| Closeout Date | 11/30/2021 |
| Work Description | PLACE HMA (TYPE A) AND MODIFY INTERCONNECTION CONDUIT AND CABLE. |
| Location Description | GLENN COUNTY IN AND NEAR WILLOWS AT VARIOUS LOCATIONS FROM COUNTY ROAD 57 OVERCROSSING TO COUNTY ROAD 33 OVERCROSSING |
| QA Service Level | 1 (Verified on 12/02/2020) |
Sample Information
| Sample Taken Date | 04/22/2021 | Sample Unique Key | 19 |
|---|---|---|---|
| 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 | 04/29/2021 |
| Sample type | Acceptance | A brief description of the sample | PG 64-16 |
| The quantity of what the sample constitutes | one out of one | From where was the sample collected | Manufacturer |
| First name of sampler or witnessed by | Brad (WITNESS) | Last name of sampler or witnessed by | McKeehan |
| Title of sampler | TET | Telephone number of sampler | |
| Laboratory sample identification | Linked DIME Sample ID | ||
| The fabricator/manufacturer/facility name | Knife River Construction - Orland Drum Plant | Transportation Laboratory (TL) Number | C724333 |
| Inspector Lot Number from the Transportation Laboratory (TL) Form | Structure unique identifier | ||
| Structure name |
Material Information
| Material Type | Asphalt Binder | Performance Grade | PG 64-16 |
|---|---|---|---|
| Modified | No | Lot number | 1 |
| Sublot number | 4 | Tank number | |
| Time of sample | HMA Supplier | KRC Orland | |
| Certified Asphalt Supplier | Valero Marketing & Supply - Benicia CA | Multigrade | No |
| Multigrade Type | Not set | Asphalt Binder Mix Number | Not set |
JMF Information
| Verification ID | JMF3513-2021-39 | Date Created | 04/02/2021 |
|---|---|---|---|
| JMF Submittal ID | JMF3511-23-2021-51 | JMF Status | Submittal Authorized For Use |
| Producer Mix ID | OR-22771000 | 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 |
|---|---|---|---|---|---|---|---|---|
| No results found. | ||||||||
Sample File Attachments
| File Name | Extension | Date Uploaded | Actions |
|---|---|---|---|
| No results found. | |||